LENAWEE HUMANE SOCIETY
Today’s Date:____________ Volunteer Application
Thank you for your interest in the Lenawee Humane Society. Please complete the application form and return it to the Receptionist.
Telephone-Home_________________ _____________________________
Work_________________ E-mail:______________________________
Age_________ Date of Birth:____________
What type of transportation is available to you?_______________________________________
How did you hear about us?_______________________________________________________
Have you ever volunteered before?____________ If so, where?__________________________
Are you doing Community Service hours for: School_________ Court________
How many hours?_______Reason for Community Service?_______________________
For court community service hours you must bring in your GREEN SHEET from the Probation Department with you when you begin your volunteer hours. That way we can record the hours you volunteer for LHS.
Do you have pets?_________If so, what kind and how many?____________________________
If not, why?____________________________________________________________
Date Available to start_________________
There are a number of opportunities available to volunteers. Please review the following and check areas of possible interest.
______SHELTER: Helping clean cages & kennels for animals; walking the animals; assisting
visitors with basic information regarding available adoptable animals;
playing with or grooming animals. These are during daytime hours only.
______OFFICE: May include typing, data entry, filing, answering the phone, mailings, etc.
______FUNDRAISERS: Helping with quarterly newsletter mailings; Bake sales, seasonal
fundraisers, etc.
What skills or special
talents do you have to offer LHS?_________________________________
______________________________________________________________________________
______________________________________________________________________________
Please give us a person to contact in case of an emergency_______________________________
Relationship to volunteer:_______________________________
Daytime phone number_________________________________
LENAWEE HUMANE SOCIETY
TERMS AND CONDITIONS OF VOLUNTEERING
1. I fully understand and agree to provide my services to the Lenawee Humane Society, hereinafter referred to as LHS, as a volunteer, without any expressed or implied promise of salary or compensation of any kind.
2. I agree to familiarize myself with LHS’ policies and procedures in direct reference to my duties as a volunteer. I will fully comply with these policies and procedures as they relate to
me.
3. I understand and agree that failure to comply with the policies and procedures of LHS as they relate to me will be grounds for immediate termination of my volunteer status at LHS.
4. I understand that LHS handles a large number of animals on a daily basis, the temperament of which is unknown to LHS staff. I agree to hold LHS harmless for any injuries, which could be sustained, from handling animals during the course of my volunteer duties.
5. I understand and agree that LHS expects high standards of moral and ethical treatment of the animals under its care, and I agree to conform to these standards.
6. I agree to release, discharge, indemnify and hold LHS harmless for any and all damages to my personal property while performing volunteer duties for LHS.
7. On behalf of myself, my heirs, personal representatives and executors, I hereby release, discharge, indemnify and hold harmless LHS, its agents, servants and employees from any
and all claims, causes of action or demands, or any nature or cause connected with my volunteer agreement.
8. I understand public relations is an important part of volunteering at LHS, and I agree to allow LHS to use any photographs of me in public relations efforts. I understand that I need
not be notified in advance of photos released for such purpose.
9. I understand that LHS agrees to instruct and inform me in such policies and procedures as relate to my specific duties as volunteer at LHS, and if I do not fully understand these
policies and procedures, I am expected to notify the instructor.
I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTAND THE TERMS AND CONDITIONS OF MY VOLUNTEER AGREEMENT, AND THAT I WILL COMPLY WITH THE SAME.
_____________________ ___________________________ ______________________
Print Volunteer’s name Volunteer’s Signature LHS staff signature
As a parent or legal guardian of the above named volunteer, I hereby give my consent to allow my child or ward to volunteer their services for LHS.
I have read the Terms and Conditions of Volunteering, and on behalf of my child or ward, I agree to all terms and conditions as set out in this agreement.
______________________ _________________________ ____________ _______________
Print parent/guardian name Parent/guardian signature LHS staff initials Date