VOLUNTEER FORM

Volunteer Form

Name *

Date *

Street Address *

City *

State *

Zip *

Home Phone *

Work Phone *

Cell Phone *

Fax

email *

employer *

profession *

If still a student, school & grade

Emergency Contact Name *

Phone *

How did you hear about us?

Have you ever been convicted of a crime in any state? *
yes
no

If yes, please provide details

Are you volunteering to fulfill a COURT ORDERED Community Service Commitment?
yes
no

# Hours Needed?

NOTE: If you need to do Court Ordered Community Service- you DO NOT need to come to orientation, however you are welcome to, so that you may continue to volunteer at GCHS after your hours are complete if you should choose to do so.
If you need a Court Ordered Community Service Application please contact: Amina Mark at: (239)332-0364 ext 304 or AminaMGulfCoastHumaneSociety.org

Are you volunteering to fulfill a SCHOOL REQUIRED Community Service Commitment?

# Hours Needed?

How many months can you commit to our program? *

Please list which days/times you could commit to volunteering: (ex. M-F 9am-5pm) *

Do you have previous experience working with animals? *
yes
no

Please explain

For Ages 13-17: Note: If you are 13-15 years old you MUST be accompanied by your parent or guardian while volunteering, and they MUST ATTEND volunteer orientation WITH YOU. If you are 16 or 17 you will need to have a special waiver signed by your parent or guardian on file before you can start volunteering.
Please note you MUST complete the entire Application form in order to be approved for orientation because space is limited.

I would like to attend the Volunteer Orientation on: (please enter DATE OF ORIENTATION)

Please bring a copy of your valid driver's license or state/federal ID for our paperwork. Thank you.

Enter this code *