About You

First Name (required)

Last Name (required)

Your Email (required)

Are you 18 or older?

yesno

Contact Info

Street Address

City

State

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zipcode

Home Phone

Cell Phone

Emergency Contact

Emergency Contact Name

Relationship

Phone

Employment

Name of Employer

Address

Business Phone

Your Occupation

Is it ok for us to contact you at your business number?

Skills and Experience

How did you hear about the ATNHS volunteer program?

Why do you want to volunteer with us?

Please tell us a little bit about yourself (ex. Music, Hobbies) what you like to do when not working or volunteering?

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

yesno

If yes, for what type of animal, where and how long?

Volunteer Details

Please check all that you are interested in:

canine carefoster caremarketingfundraisingmedical careother

If other, please specify how you would like to volunteer

Do you know any ATNHS Volunteers?

yesno

If yes, Volunteer Name

Relationship

Have you volunteered with us before?

yesno

If yes, please list when and reason for leaving.

Are you a member of any other animal welfare organization?

yesno

If yes, please specify how you participate.

Have you adopted an animal from ATNHS before?

yesno

If yes, please tell us who you adopted and when.

Do you have any allergies or conditions that might affect your volunteer work?

yesno

If yes, please describe

Do you have a valid driver's license

yesno

If no would you have access to transportation to the kennel?

yesno

Personal or Business Reference #1

Name

Relationship

Day Phone

Evening Phone

Personal or Business Reference #2

Name

Relationship

Day Phone

Evening Phone

Medical Training

Do you have any medical training

yesno

If yes, please describe your training

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