This application is for court-mandated community service opportunities only. If you are NOT currently facing any criminal charges, please return to furryfriendsrefuge.org/how-to-help/how-to-volunteer/ and fill out the appropriate form. Name* First Last Email* PhoneAddress* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Your date of birth*Please note that if you are UNDER 18, a parent/guardian must sign the waiver at the bottom of this form. MM slash DD slash YYYY Employer Emergency contact name First Last Emergency contact phoneAre you willing to undertake any task we assign you in order to fulfill your legal requirements?* Yes No Current charges*Please describe in detail the circumstances surrounding your charges.Service requirementCriminal history*Please describe in detail the circumstances of your criminal history. Write "N/A" if this is your first charge.Prior experience with animals (check any that apply) Experience with my own pets Worked/volunteered in a shelter or with a rescue Pet-sitting Animal behaviorist/trainer Other Relevant skillsVOLUNTEER AGREEMENT AND WAIVER (parent must sign if under 18)*I recognize that working with animals places me at physical risk, and I agree to assume that risk. Furry Friends Refuge has taken measures to ensure reasonable safety for me as a volunteer. It is possible, however, that accidents or injuries may occur while I am volunteering on Furry Friends property or any other location where I may be working as a Furry Friends volunteer. In such an event, I release Furry Friends Refuge from any and all claims and causes of action that I may have arising from an injury or damage sustained during my volunteer work with the organization. I also will hold harmless any other locations I may volunteer at for injury or illness caused by the animals I come into contact with in my volunteer duties. I agree to allow Furry Friends to use my photo or likeness taken during volunteer activities in promotion of the organization’s programs and mission. I agree that I will respect the positions and policies of the organization. While personal opinions regarding care and other issues may vary, I will follow the positions and policies set out by Furry Friends as I am volunteering as a representative of the organization. If you are 18 or older, type your first and last name into the box below to indicate your acceptance of these terms. This will act as your signature. If you are under 18, your parent or guardian must review this agreement first, then he/she must type his/her name below. Parent or guardian’s typed name below shall act as a signature indicating a waiver of liability for minor volunteer. Parents and guardians of minors under 16 must also submit their own volunteer application and must accompany minor at all times. First Last PhoneThis field is for validation purposes and should be left unchanged. Δ Share this:TwitterFacebookLike this:Like Loading...