Volunteer Application -

HSSCM is currently only accepting volunteers for cat socialization and outdoor landscaping work. YOU MUST BE AGED 16 OR OLDER TO VOLUNTEER WITHOUT A PARENT. If under age 16, please have your parent fill out this application as the primary volunteer.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Parent or Guardian’s Name (if under 18): *

Are you a student? *

School and Grade Level: *

Are your volunteer hours required for school, NHS, probation, or anywhere hours must be tracked and reported upon? *

If yes, please explain nature of requirement:

Why do you want to volunteer with us (check all that apply) *

Want to play/socialize cats
Want to walk dogs
Want to help a local nonprofit organization
Need for school or other reportable hours

Will you have children or other individuals volunteering with you?

Name and Age of Child volunteering with you: *

Shirt size of volunteer(s): *

Have you volunteered here before? *

If yes, when?

Have you ever volunteered at another animal shelter/rescue before? *

If yes, please list organization and approximate dates:

Shelter Pal hours are Tuesday - Friday from 12:30pm to 3:30pm. Saturdays and Mondays are reserved for scheduled gardening volunteers/groups. Shelter Pals must commit to volunteer a minimum of four hours per month for six months. What days and times are you most likely to volunteer? (list the times and days you are able to work) *

Are you looking to volunteer seasonally or year-round? If seasonally, list the months you are looking to volunteer: *

Do you have any pets in your home? *

List current pets' names, types of animals, breeds, and ages *

Are ALL current pets in the home spayed or neutered? *

If animals in home are not spayed/neutered, please explain why:

Please note that you will be working in an environment with zoonotic diseases that can be carried home to your pets. It is highly recommended that you keep your pets up to date on vaccinations while working with the shelter pets. Are all current pets in your household up to date on their vaccinations? *

Name and Location of current veterinarian:

Do you have any allergies and/or medical conditions we should be aware of? (Ex. Peanut Allergy; cannot walk large dogs; etc.) *

If yes, please explain: *

Emergency Contact Name: *

Emergency Contact Phone Number: *

Please check all of the following that you are willing and able to do: *

Work with Cats
Gardening
Snow Removal/Mowing
Special Events

Personal Reference Name, Phone Number, and Relationship *

HSSCM Release: I hereby release, indemnify, and hold harmless HSSCM, its directors, employees, successors, legal representatives, sponsors, and supervisors of all its activities, from any and all claims, causes of action, and liability arising from or in any way connected with my volunteer participation with the Humane Society of South-Central Michigan. I understand that I am expressly assuming all risk, including but not limited to all risk of injury and disease associated with my volunteer participation. I further grant HSSCM permission to use, without cost, any photographs, videos, or audio taken of me during my volunteer services. This certifies that I understand that I must attend Shelter Pal orientation and receive, read, and understand the contents of the volunteer training manual prior to volunteering with the Humane Society of South-Central Michigan.

Volunteer Signature *

Volunteer Age (if under 18):

Parent or Guardian Signature (if child is under age 18):