Street address

City State Zip

Email address

Employer Occupation

Birth Date (optional) Age Group 18-36 37-60 Over 60

Education 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade BS/BA Masters PhD

Major Do you speak a foreign language? Yes No

How did you find out about our volunteer program?
Internet Advertisement Newspaper TV Flyer Other
Specify

Please tell us briefly why you would like to become a volunteer for Hi Tor Animal Care Center

Do you have any prior experience as a volunteer? Yes No

If yes, what organizations?

What were your duties?

Have you had prior experience at an animal shelter or in a related field? Yes No

Have you had any formal education in companion animal care or animal welfare? Yes No

What companion animals do you have now?

Have you had in the past?

Are your companion animals spayed/neutered? Yes No?

Are you a member of any animal welfare organization? Yes No?

How do you participate?

Volunteering for Hi Tor Animal Care Center is not only animal related, it also involves constant contact
with the general public and Shelter staff.  How do you feel about interacting with all types of people?

Are you comfortable taking direction from others?

Although we make every effort to see that the animals in our care are adopted, there are instances
when an animal becomes unadoptable (this will be explained thoroughly in Orientation) and is
euthanized (humanely “put to sleep”).  How do you feel about this?

What are your special skills, interests, hobbies?

Do you have a driver's license? Yes No

Do you own a car? Yes No

Do you have health insurance? Yes No
(copy of insurance card required)

Do you have any physical, medical or psychological limitations or disabilities Yes No
(i.e., heart condition, mental illness, allergies, back injuries, epilepsy, etc.)?

  If yes, please explain?

Failure to disclose any limitations prior to acceptance will result in dismissal from the Volunteer program.

Please indicate the days of the week and hours you are available.
Volunteers are usually needed between the hours of 8 a.m. and 5 p.m.

When will you be ready to begin volunteering?

Are there any restrictions such as work/school schedule that may affect your availability for volunteer work? 

If you were referred to us through some other agency for community service, please indicate the agency,
name of contact person and, if applicable, the number of hours you are required to volunteer.
 

In case of emergengy who should we notify?

First name Last name

Relationship Street address

City State Zip

Home phone Cell phone Work phone

HI Tor Animal Care Center Volunteer Opportunities
Please let us know which volunteer opportunities interest you most
(check as many as apply)

ANIMAL CAREGIVER – Socialize, exercise and groom animals.  Clean kennels.  Feed and water animals.  Assist shelter staff with the public.  Provide transportation for animals to veterinarian office or to other welfare groups/adopters.
Dogs Cats No Preference Transport

ADOPTION COUNSELOR – Screen potential adopters to insure the animal’s placement in a loving and secure home.  Additional training on screening forms and adoption contracts is required.
At Shelter Offsite Adoption No Preference

FOSTER CAREGIVER – Provide a temporary home for kittens, puppies, or animals with special needs until they can be adopted.  Additional application, screening, training and home visits are required.

ADOPTION FOLLOW-UP – Contact new adopters to see how the adoption is going and to offer support with training and behavior issues.  Additional training is required.
At Shelter From Home

OFFICE/COMMUNICATIONS/COMPUTER –
Perform Standard Office Functions . Assist Shelter Director, Public Relations Coordinator, etc., with clerical tasks.  Preferably with access to a personal computer.
Assist with data input of animal records (at Shelter).

FUNDRAISING/PUBLICITY – Varies with activity.  May include planning, logistics, and coordination of activity or special event.
Fundraising/Special Events Maintain Fundraising Canisters
Special Mailings Writer for Newsletters, Publicity
Photography Printing Work

Additional Needs

From time to time we are in need of skilled labor (carpenter, licensed electrician, licensed plumber, etc.) 
If you have any skills and can donate your time, please specify how:

Hi Tor Animal Care Center – Waiver & Release of Liability

I understand that in the course of my volunteer activities with Hi Tor Animal Care Center, I will come into contact with domestic animals.  I acknowledge that Hi Tor Animal Care Center is not the owner of said domestic animals but the keeper, and thus has no prior knowledge of said domestic animals’ behavioral tendencies and cannot be held responsible for the behavior of same.

I fully understand that the behavior of domestic animals is sometimes unpredictable and that some domestic animals are capable of inflicting serious personal injury or death, as well as extensive property damage.  Knowing the risks of handling domestic animals, I agree to assume those risks and to release, indemnify and hold harmless Hi Tor Animal Care Center and any of its Officers, Directors, Employees, Agents or Contractors for any and all personal injury and property damages resulting from said volunteer work.

I further understand that volunteers are not classified as employees, agents or servants of Hi Tor Animal Care Center and thus any injuries I might sustain during the course of my volunteer activities are not entitled to coverage under the Hi Tor Animal Care Center’s worker’s compensation policy.

In the event of injury, I agree to pay any and all medical and other costs in their entirety.

I waive my right to legal action against the Hi Tor Animal Care Center in regard to my volunteer duties for same.

I understand the potential of exposure to rabies and will obtain an inoculation from my own physician, at my own expense, if I so choose. 

I know of no medical or other condition which would prevent me from volunteering at Hi Tor Animal Care Center.

I agree to abide by all the policies and procedures of Hi Tor Animal Care Center.  I understand that I will be terminated from the volunteer program if I fail to do so.

SIGNATURE DATE

WITNESS DATE

First name Last name

Street address

City State Zip

Home phone Cell phone Work phone

Emergency phone