Court Ordered Hours Volunteer Application
**Notice to Prospective Community Service Workers** Thank you for your interest in completing your hours with the Humane Society of Marion County. Please be advised that submitting this form does not guarantee acceptance into our volunteer program. Kindly await a response from our team before visiting the shelter. Additionally, please note that there is a $10 administrative fee required at the time of sign-up, payable in cash ONLY. Thank you for your understanding. Sincerely, Kirstin Tanner Shelter Administrative Coordinator Humane Society of Marion County 352-873-7387 ext 204.
Personal Information
First Name
*
Middle Name
*
Last Name
*
Date of Birth
*
Phone Number
*
We will contact you with questions that may arise.
Email address
*
We will email you your approval/denial & waivers.
Do you have any physical limitations that would prevent you from doing any of the following jobs?
*
Community Service Task List Tasks include but are not limited to the following: • Wipe down walls • Clean sinks • Clean breakroom/kitchen • Clean bathrooms • Empty trash cans • Wash out trash cans • Pooper-scooper the outside yards & runs • Fill in any holes in yards & runs • Pick up trash in the parking lot and along the overpass along the fence line • Wipe down shelving • Dishes • Sanitizing bins • Sweeping & Mopping • Sanitizing • Scrubbing Kennels • Any other chores assigned by staff or management
No
Yes
If yes, please describe.
Charge Information
What were your charges?
*
How many hours are you sentenced to?
*
What County did your charges originate in?
*
