Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone *

(###)

###

####

Cell Phone

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Youth volunteers - are you volunteering as part of a school/community program?

Yes

No

Youth volunteer parent/guardian name

First Name

Last Name

Willing to work with *

(please check all that apply)

Cats

Dogs

Other Animals

Shelter Maintenance

(please check all that apply)

Cleaning

Painting

Gardening

Minor Repairs & Carpentry

Community & Fundraising

Community Outreach

Fundraising

Secretarial & Office Suppor

Reception (includes greeting the public, answering questions, escorting visitors to adoption areas, answering phones and making follow up calls to adopters)

Office/Clerical (includes data entry using Microsoft Office Suite and other computer skills, filing, preparation of bulk mailings, etc.)

Monday

9AM - 11AM

Tuesday

9AM - 11AM

11AM - 1PM

2PM - 4PM

Wednesday

9AM - 11AM

11AM - 1PM

2PM - 4PM

Thursday

9AM - 11AM

11AM - 1PM

2PM - 4PM

Friday

9AM - 11AM

11AM - 1PM

2PM - 4PM

Saturday

9AM - 11AM

12PM - 2PM

Sunday

9AM - 11AM

12PM - 2PM

We occasionally experience an unexpected need for help. (e.g. a weather emergency or a regularly scheduled volunteer's unplanned absence.) Would you be able and willing to be placed on our emergency phone contact list to perhaps fill such a need? *

Yes

No

Are you willing to work on a holiday if necessary and with sufficient notice? *

Yes

No

Criminal Background Check *

Do you agree to a local criminal background check done by the Columbia Police Department (at no cost to you)?

Yes

No

I agree to the above *

By typing your name you are signing that you agree to the above statement.

First Name

Last Name