Animal Samaritans Volunteer Application
In order to help us learn a little more about you, please fill out the following application questions. Thanks!
A Friendly Reminder: *Please note that the majority of the application/orientation process is currently done online/via email* Please make sure your email is correct. Thanks!
***ATTENTION*** APPLICATIONS SUBMITTED FROM 6/7-6/17 WILL NOT BE REVIEWED UNTIL THE WEEK OF 6/17. THANK YOU FOR YOUR PATIENCE.
First and Last Name *
Your answer
Date of Application: *
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Street Address (Name): *
Your answer
City, State, Zip Code: *
Your answer
Home Phone Number: *
Your answer
Cell Phone Number: *
Your answer
Email: *
Your answer
Birthdate: *
MM
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DD
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Emergency Contact First and Last Name: *
Your answer
Emergency Contact Phone Number: *
Your answer
Emergency Contact's Relationship to Volunteer: *
Your answer
*IF APPLICANT IS UNDER 18*
(Critter Camp Counselors must be 16 and over.)
Age of Junior Volunteer
Your answer
Parent/Guardian Name:
Your answer
Parent/Guardian Home Phone Number:
Your answer
Parent/Guardian Cell Phone Number:
Your answer
Parent/Guardian Email:
Your answer
AREAS OF INTEREST: (Check all that apply.) *
Required
SPECIAL SKILLS (Check all that apply.) *
Required
*Note: Some jobs may also require lifting up to 50lbs.
VOLUNTEER EXPERIENCE (Please List.) *
Your answer
AVAILABILITY:
Are you a year-long resident? *
If no, what is your summer address and the months you are in the desert?
Your answer
Summer Address:
Your answer
"I am in the desert from... ________to________"
Your answer
*DAYS AVAILABLE (Mark the mornings or evenings for the days you are available ONLY.)*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you able to perform the essential function of the job for which you are applying, either with or without reasonable accommodations? *
If no, describe the functions that cannot be performed and what accommodations are required?
Your answer
Please list any allergies, medical problems or other issues that we should be aware of to insure a safe volunteer environment.
Your answer
*APPLICANTS WHO COMPLETE THIS FORM IN FULL WILL BE SENT AN ONLINE ORIENTATION, AND WILL BE SCHEDULED WITH A ONE-ON-ONE TO RECEIVE FINAL INSTRUCTION BEFORE THEIR VOLUNTEER START DATE.*
QUICK VOLUNTEER GUIDELINE OUTLINE:
***AS A VOLUNTEER, ANIMAL SAMARITANS WILL PROVIDE YOU WITH A T-SHIRT AND NAME TAG LANYARD. YOU MUST ALWAYS WEAR IDENTIFICATION (NAME TAG) WHILE VOLUNTEERING FOR ANIMAL SAMARITANS.

***VOLUNTEERS ARE RESPONSIBLE FOR KEEPING TRACK OF THEIR SCHEDULES AND LOGGING THEIR HOURS. YOU CAN DO THIS BY FILLING OUT THE "VOLUNTEER TIME FORM" WHICH IS FOUND IN THE VOLUNTEER SECTION ON OUR WEBSITE. THIS IS VERY IMPORTANT.
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***Volunteers should be polite and helpful at all times. All people and animals are to be treated with respect and courtesy.

***Volunteers should refer questions from the public regarding Animal Samaritans policies to the staff only. Volunteers should maintain confidentiality in regards to Animal Samaritans clients, donors and business.

***Volunteers must accept the guidance and decisions of the professional staff person responsible for volunteer activities. Problems and disagreements should be taken to the Volunteer Coordinator.

***Any accident or injury to either a person or animal should be reported to the Volunteer Coordinator IMMEDIATELY.

APPLICANT NAME: *
Your answer
APPLICANT INITIALS: *
Your answer
THANK YOU FOR YOUR DESIRE TO VOLUNTEER WITH US!
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