HSAC Volunteer Application Form

HSAC would like to encourage the participation of Volunteers who support the following purposes: To receive surrendered, neglected, and abused animals brought to the shelter; to place them in good homes; to humanely handle those which cannot be placed; and to educate the public about the humane treatment of animals. All potential volunteers are required to attend an orientation/training with a staff member, followed by a facility tour of their assigned location. Please complete this application form if you are interested in becoming an HSAC volunteer. Once you complete the form, click the submit button at the bottom. A member of Volunteer Services will review your application and be in touch. Please keep in mind that we are a small, busy non-profit animal shelter with limited hours of operation, so your patience is appreciated. Thank you!

Humane Society of Adams County,Inc. (Ohio)

How did you hear about us?
First Name (required) *
Last Name (required) *
Date of Birth (required) * MM/DD/YYYY
Home Phone (required) *
Cell Phone
Street Address (required) *
City (required) *
State (required) *
Zip Code
E-Mail Address *
First Name of Emergency Contact * Please provide contact information for individuals that you wish to be contacted in the event that you are in an emergency situation.
Last Name of Emergency Contact * Please provide contact information for individuals that you wish to be contacted in the event that you are in an emergency situation.
Home Phone of Emergency Contact * Please provide contact information for individuals that you wish to be contacted in the event that you are in an emergency situation.
Cell Phone of Emergency Contact * Please provide contact information for individuals that you wish to be contacted in the event that you are in an emergency situation.
Relationship of Emergency Contact Type a description of your relationship with this emergency contact person (i.e. mother, sister, friend).
Please describe the days and times you are usually available to volunteer. *
Tell us why you are interested in volunteering with our organization specifically.
Tell us about your experience volunteering. *
Tell us about your experiences with handling animals.
I understand that the handling of animals and other Volunteer activities on behalf of the Humane Society of Adams County (HSAC) may place me in a hazardous situation and could result in injury to me or my personal property. On behalf of myself, and my heirs, personal representatives and assigns, I hereby release, discharge, indemnify and hold harmless HSAC and its directors, officers, employees and agents from any and all claims, causes of action and demands of any nature, whether known or unknown, arising out of or in connection with my Volunteer activities on behalf of HSAC. At no time will I interfere with the operations of or the decisions made by HSAC, whether at the shelter or outside of the shelter. I understand that such interference may result in the termination of my volunteer privileges. *	NoYes

Humane Society of Adams County,Inc. West Union, Ohio