Animal Control Volunteer Application

If you are not able to complete the form in one sitting, scroll to the bottom and click the “Save and Continue Later” link. Doing this will save a copy of the information you’ve entered and allow you to return and finish later.

Identification
Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Social Security Number (SSN)*
Driver's License Number*
State of Issue*
Contact Information
Home Address*
Street Address Address Line 2 City State ZIP Code
Mailing Address (if different)
Street Address Address Line 2 City State ZIP Code
Email Address*
Home Phone*
Work Phone
Mobile Phone
Other Names Used
Emergency Contact
Name*
First Last
Phone*
Alternate Phone
Personal References
First Reference
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Second Reference
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Additional Information
Current Occupation
Have you ever been arrested for any criminal offense?*
- no
- yes
Please explain the circumstances of your arrest:
Volunteering with Animal Control
Animal Experience
Please describe your general level of experience with animals.
Formal Training
Please describe any certified animal health training such as grooming, veterinary experience, obedience training and/or animal behavior training.
Previous Work Experience
Please describe your previous work experience at an animal shelter or rescue facility.
Affiliations
Please describe your affiliations with any other animal shelters and/or animal rights organizations.
Signature and Certification
Certification*
I have read the entire text of this application and understand it completely. The statements I have made are correct and true. I understand that making false statements on this application is a crime. If I have made false statements in this application, I am subject to prosecution and my application will automatically be denied or revoked.
- I certify that I intend my electronic signature on this application to be the legally binding equivalent of my traditional handwritten signature.
Signature*
Enter your full legal name.
Date Signed*
MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

Identification

Contact Information

Emergency Contact

Personal References

Additional Information

Volunteering with Animal Control

Signature and Certification