Volunteer Application

Tuesday, March 09, 2010

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Volunteer Application

Your Information

Prefix

Your Name (First/Middle/Last)

Street

Apt.

City

Country

State

Postal Code

Home Phone

Work phone

Cellular Phone

Best Time To Call

Email Address

If employed, please indicate name and address of current employer

May we call you at work?

What is the highest level of education have you have completed?

If other, please specify

Who should we contact in case of an emergency?

Emergency Contact's Name

Emergency Contact's Address

Relationship to you

Phone Number 1

Type

Phone Number 2

Type

Do you have any physical or medical disabilities that may hinder you from participating in any program?

If yes, please explain

Availability

Please list the hours you are available each day

Sunday

Thursday

Monday

Friday

Tuesday

Saturday

Wednesday

When are you available to start volunteering?

What month(s) are you available to volunteer?

Your Skills & Interests

Have you had any formal education in pet care or animal welfare?

If yes, please explain:

Are you volunteering through some other agency (e.g., school, court)?

If yes, please indicate agency, contact name and number of hours you are required to volunteer

Please check all areas you are interested in volunteering for
Animal Services Adoption CounselorSpecial Events (e.g., annual dog walk)
Operation Fix-ItBulk Mail Projects
Pet VisitationClerical and Office Help
Educational ProgramsCrafts

Do you have any special skills we should know about?

If yes, please describe:

What do you hope to gain from your volunteer experience?

What pets do you own now?

What experience do you have working with the public?

Have you ever been convicted of a felony?

If so, please list the date and a provide a brief explanation:

Are you over 18 years of age?

If no, please list your age:

How did you hear about KHS volunteer opportunities?

Would you like to receive our quarterly newsletter?

Would you like a hardcopy of our newsletter mailed to you?

To receive an electronic copy of our newsletter, please click on the SIGN UP image above to register.

This application will be forwarded to our Volunteer Program Coordinator. You may reach the KHS office by phone at (269) 345-1181 with any questions you may have.

Submit My Volunteer Application

4239 South Westnedge Avenue, Kalamazoo, Michigan, 49008
p.269.345.1181 | f.269.345.1290

Your Information

Availability

Your Skills & Interests

4239 South Westnedge Avenue, Kalamazoo, Michigan, 49008 p.269.345.1181 | f.269.345.1290

4239 South Westnedge Avenue, Kalamazoo, Michigan, 49008
p.269.345.1181 | f.269.345.1290