Last Name  *

Street Address  *

City  *

State  * CA 

Zip  *

Cell Phone:  *

Home Phone:

Task(s) Interested In: (Hold down ctrl for pc/command for mac to select multiple items)  * Administrative Duties  Adoption Events  Auction Item Solicitation  Bake Sales  Cat Handling  Dog Training  Dog Walking/Socialization  Event Coordination  Fundraising/PR  Grooming  Holiday Events  Photography  Promotion  Shelter Transport  Web/Graphics  Youth 

Other:

Are you 18 yrs of age or older?  *  yes   no 

Would you be able to show valid ID?  *  yes   no 

Emergency Contact Name:

Emergency Contact Phone:

Flexibility of Schedule:  *  Fixed Schedule   Seasonal Schedule based on Job or School   Changes Frequently  

Hours Per Month:  1-3   3-6   6-10   10+ 

Please select the days of the week you are consistently available to volunteer: (Hold down ctrl for pc/command for mac to select multiple items) Sunday  Monday  Tuesday  Wednesday  Thursday  Friday  Saturday 

Time Of Day Available: (Hold down ctrl for pc/command for mac to select multiple items) Mornings  Afternoons  Evenings  Anytime 

Schedule Details/Comments:

Do you have any prior experience volunteering with animals?  *  yes   no 

If yes, with what organization(s)?

Please list any skills you may have that will assist you in volunteering at The PRC:

Please list any limitations that may affect your ability to volunteer:

Please list any animal welfare organizations you belong to or are affiliated with:

Are you aware that under extreme circumstances, you could be subject to scratches or bites from the animals due to any reason or occurrance?  *  yes   no