Volunteer Form

Date *

Name *

Date of Birth *

Address *

Email Address *

Home Phone

Cell Phone

Work Phone

Emergency Contact and Phone Number

Do you have a valid drivers license?

Are you a student?

Are you employed?

Time Worked

Job Skills

How did you hear about Effingham Co. Humane Society?

Why are you interested in volunteering?

Previous volunteer experience

Have you previously worked with animals?

Have you ever been convicted of a crime involving cruelty to animals?

Are you allergic to any animals?

What types of allergies?

How many animals do you have and what types? If interested in fostering, list your vet reference name and phone number.

Interests, Skills, Hobbies

What types of volunteer work would you like to do?

That animals are different from human beings in their response to human action.
That the actions of animals are often unpredictable.
That the Effingham County Humane Society makes no claim as to the temperament, health, or mental disposition of any animal a volunteer may be working with at any given time.
That I am volunteering at my own risk and am aware of the risks involved
That I will accompany and closely supervise my child under age 16, who is experienced with animal handling, in order for him/her to handle any of the animals
That I agree the animals must stay in a designated area during events unless removal is necessary and approved by that specific animal's caregiver.
That I agree only experienced adults or experienced children over the age of 16 can remove any animals from their pens or walk the animals during events.

I hereby release and discharge the Effingham County Humane Society forever from liability for any injury, illness, or damages caused or sustained in the course of my volunteer work with the Effingham County Humane Society and from any action, claims, suits, or demands whatsoever that may arise as a result of such injury, illness, or damages. I further represent that I possess medical coverage or the means to pay for medical treatment involving any activity undertaken in the course of my work and activities with the Effingham County Humane Society.

I, as a volunteer for the Effingham County Humane Society, agree to abide by all policies and procedures of the Society and will do my best to provide a clean, safe, and caring environment for the animals during their stay. I also understand that due to lack of volunteer homes/space, the health of the animal, and temperament, some animals may be turned down.

Volunteers are expected to comply with the animal care procedures and operate in accordance with the policies and mission of the Effingham County Humane Society. Any volunteer in violation of the policies and procedures or those found to be disruptive to the daily functioning of the Effingham County Humane Society may be prohibited from volunteering or restricted in volunteering duties.

By selecting submit, you do hereby electronically sign this document