VOLUNTEER FORM
CARBON COUNTY FRIENDS OF ANIMALS
77 WEST 13TH STREET
JIM THORPE, PA 18229
PHONE: 570-325-9400
Today's Date:
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Volunteer's First Name:
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Volunteer's Last Name:
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Street Address (include apartment or lot #):
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City:
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State:
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Zip Code:
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Date of Birth:
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Contact Phone #:
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Volunteer's Contact Email Address:
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May we add your email address to our mailing list?
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No
Yes
Name of Emergency Contact:
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Emergency Contact Phone:
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Please Select from the Following:
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I am volunteering
I owe community service hours
I need to complete a Senior Project
Please Select from the Following:
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I am interested in volunteering at the shelter building
I am interested in assisting with fundraisers
Both
If completing hours, please enter the amount of hours needed:
How did you hear about Carbon County Friends of Animals?
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Search Engine
Facebook
Youtube
Twitter
Instagram
Other Social Media
Email
Radio
TV
Newspaper
Word of Mouth
Other
I understand that I must report directly to the Manager or employee in charge upon arrival.
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No
Yes
I understand that I must keep confidential all information acquired during the service.
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No
Yes
I understand I must provide advance notice of dates and times the volunteering will be rendered and if unable to attend as scheduled, I am required to phone the shelter during business hours and advise staff of absence.
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No
Yes
I authorize the shelter to seek emergency medical treatment in case of an accident, injury, or illness.
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No
Yes
I, and my parents or guardians (if under the age of 18), understand that I am not covered by workman's compensation.
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No
Yes
I understand that I must abide by the terms of this agreement or will otherwise be terminated from the program by the shelter Manager and/or a Board Member.
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No
Yes
I understand that safety must always come first.
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No
Yes
I understand that I must not interfere with the daily operations of the shelter and will not loiter or occupy seating behind the front desk.
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No
Yes
I understand that I must refer all customer questions on policies, adoption, etc. to the shelter staff.
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No
Yes
I understand that I must clean up after myself and that things must be returned to their original locations.
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No
Yes
I understand that I must not handle ANY animal without first checking with the Manager or staff. I also will not touch ANY animal being turned into the shelter as it may not be vaccinated and may bite or scratch.
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No
Yes
I understand that I must not enter the Top Cage rooms, which include (but are not limited to), new admits, the mom & kitten room, and the sick room, without permission from the shelter Manager.
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No
Yes
I understand that kittens must not be removed from the room or cage they are housed in without staff approval.
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No
Yes
I understand that I must report ANY injury or problems discreetly to the shelter Manager or to a staff member.
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No
Yes
I, and my parents or guardians (if under the age of 18), understand that volunteering at an animal shelter contains certain risks due to exposure to animals and other illnesses. The volunteer may be exposed to or may carry home an illness to his/her own pet.
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No
Yes
I understand that tobacco products are not permitted on shelter grounds. Adult volunteers may use tobacco in his/her vehicle while on break but may never DISCARD cigarette butts or debris on shelter grounds.
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No
Yes
I understand that the use of cell phones is prohibited at the shelter
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No
Yes
I understand that use or possession of illegal drugs or alcohol shall result in immediate termination and possible criminal action.
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No
Yes
I understand that if I own a pet, it is highly recommended that upon my return home, all clothing be immediately placed into a secure area (i.e. washing machine) in order to avoid the spread of illness to my pet.
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No
Yes
I understand that if I am feeling unwell and/or have either tested or tested positive for Corona Virus (covid-19) I must inform the shelter Manager immediately.
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No
Yes
By signing below, I, and my parents or guardians (if under the age of 18) understand that volunteering at Carbon County Friends of Animals is not without certain risks. I, therefore, agree to abide by shelter policies and comply with directives set by staff, the shelter Manager and by the Board of Directors. I hereby release and hold harmless, Carbon County Friends of Animals, its employees, the shelter Manager, the Board of Directors, other volunteers, and any family or friends from any and all liability of any nature, for injury or damage to property that the volunteer may suffer while on shelter grounds, including, but not limited to, traveling to and from the shelter or any shelter function or while attending any shelter function.
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No
Yes
Signature of parent or guardian (if under the age of 18):
Clear
Signature of Volunteer:
Clear
Revised: December 2022