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Volunteer Application Form
Email address *
Name *
First and last name
Address *
City *
Email *
Birthday
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Phone number *
Which position(s) are you interested in? *
Required
Describe your previous volunteer experience
What pets are currently in your home? Please list breed, sex, age and if spayed/neutered. *
How did you hear about our volunteer opportunities? *
IN CASE OF EMERGENCY CONTACT *
List any medical condition to be considered an emergency:
Have you ever been convicted of a violation of the law? If yes, please list offenses and an explanation on the back of this application. You must disclose a felony conviction that has been judicially dismissed pursuant to Penal Code Section 1203.4. Do not include traffic citations, arrests that did not result in convictions, any offense which resulted in referral to or participation in any pretrial or post trial diversion programs, convictions that have been expunged under Penal Code Section 1203.4, convictions for violations of Health and Safety Code Section 11357(b) or (c), 11365, 11550 (pertaining to certain marijuana offenses) which occurred more than two years before the date of this application. I certify that all statements made in this application are true, and I understand that any untrue or misleading answers are cause for rejections of this application or dismissal as a Tiny Pitbull volunteer. *
Signature
Date *
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