Contact Information

Title:

 Ms. Mrs. Mr. Dr.

*Name:

Street Address:

City:

State:

Zip Code:

Age:

 Under 16 16 or 17 18 or older

*Phone:

Best time to call:

 Morning Day Evening Any time

*Email:

Position applying for

*Position:

Volunteer Interests

Please tell us in which areas you are interested in volunteering

 Fostering Cats Writing newsletter articles and brochures Fostering Dogs Management/Leadership opportunities Assist with Adoption Events Designing/Developing Pet Haven flyers & brochures Spay/Neuter Initiative Outreach/Humane Education Administrative tasks from home Fall Benefit/Fundraising Transporting animals Advocacy/Legislation Transporting supplies Other

Where did you hear about Pet Haven?

Special Skills or Qualifications

Please list any special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities such as hobbies or sports, that you are willing to offer to Pet Haven.

Work and Volunteer Experience

Please summarize your work and volunteer experience.

Availability

During which hours are you generally available for volunteer assignments?

 Weekday mornings Weekday afternoons Weekday evenings Weekend mornings Weekend afternoons Weekend evenings

Interest in Pet Haven

Please describe your current experience or involvement with Pet Haven Inc. of Minnesota. If you are new to Pet Haven, please explain why you are interested in becoming involved with Pet Haven.

Person to Notify in Case of Emergency

Name:

Relationship to you:

Daytime Phone:

Evening Phone:

Cell Phone:

References

Please provide the names and contact information for three individuals, other than family members, who can provide professional or personal references.

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

*Electronic Signature (Full Name):

*Date:

Our Policy

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

We value your privacy. Pet Haven does not sell or provide personal information about our volunteers to any other organization. The data collected on this form will be available only to Pet Haven volunteers whose assigned responsibilities require access to this information.

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