Volunteer Application Which volunteer opportunity are you interested in?*Select One OptionCanine CollegeHelpline - Cat Placement CounselorHelpline - Community Cat CounselorHelpline - Dog Adoption CaseworkerSanctuary - Canine Socialization (SPECIFIC SHIFT)Sanctuary - Feline SocializationSanctuary - GroundskeepingName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Cell PhoneAlternate PhoneInitial Contact MethodCallEmailTextWe will be contacting you to discuss Our Companions and our Volunteer Program. Please check off the preferred communication method for our initial contact.Employer Occupation/Title Do you have any physical, medical, or psychological limitations or disabilities that might keep you from participating in any area of the volunteer program (e.g., heart condition, back injury, allergies, etc.)? Yes No If so, please explain.Emergency contact: Name, Phone Number, RelationshipHow did you hear about this organization?ReferencesPlease provide a name and phone number of two references who are not relatives.Reference 1 Name Reference 1 Phone Reference 1 Email Reference 2 Name Reference 2 Phone Reference 2 Email Birthday (Month, Day) Volunteer ExperienceOrganization Name Date of Service Duties Organization Name Date of Service Duties Skills, Hobbies, Special InterestsPlease list the types of animals who have shared your home.Why did you decide to apply to volunteer with Our Companions?Do you have any questions or concerns about Our Companions' mission or philosophies? If so, please explain:Have you ever been convicted of a crime, including a misdemeanor? Yes No If so, state where, when, and nature of offense: Are there any legal charges pending against you? Yes No If so, please explain. In signing this application, I understand and agree to the following:I agree to attend all required training classes and to abide by the Volunteer Policies and Procedures as presented to me by Our Companions Animal Rescue. I give Our Companions permission to use photographs or video footage of my volunteer activities should it benefit the volunteer program or the organization. I understand that, as a volunteer, I may gain access to information about the organization, customers, or staff that is confidential. I agree to respect and maintain the confidentiality of all donors, customers, volunteers, staff, and other individuals working with Our Companions both on and offsite, during and out side of volunteer hours. I am at least eighteen (18) years of age and legally competent to execute this Volunteer Service Agreement and Release; or in the event that the volunteer is under the age of eighteen (18), that I am his/her parent or legal guardian and I am legally competent to execute this Volunteer Service Agreement and Release. I understand that Our Companions does not provide insurance or worker’s compensation coverage for me or my child.Sign Name First Last Application Date*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920If you are volunteering with a minor, please complete this section:I am volunteering with child under the age of 18 and have read and understand Our Companions policy on Minor Volunteers.Child's Name First Last BirthdateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child's Email Child's Name First Last BirthdateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child's Email CAPTCHAUntitledFirst ChoiceSecond ChoiceThird Choice
