Volunteer ApplicationAnimal Shelter Volunteer Application Friends of Orange County Animal Shelter Volunteer ApplicationContact InformationComplete this form to apply to become a volunteer at the shelter. Answer all questions truthfully and to the best of your ability.Applicant's Name * Applicant's Name First Name First Name Last Name Last Name Applicant's Email * Phone # * Birthday * 18 Years or Older * Yes NoVolunteer's Home Address * Volunteer's Home Address Volunteer's Home Address Volunteer's Home Address City City State StateAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Zip CodeEmergency Contact * Emergency Contact First Name First Name Last Name Last Name Emergency Contact Phone Number * Emergency Contact Alt. Phone Number Emergency Contact Email Address Volunteer Questionnaire Volunteer Availability Why are you interested in volunteering with the Orange County Animal Shelter? How did you hear about our organization? Do you have any pets? Please tell us about them. Do you have any allergies or physical conditions which might affect your volunteer work? If so, please describe. Are you a member of any other animal welfare organization? If so, please provide details. Do you have any formal training in pet care or animal welfare? If so, please provide details about this training, including when and where it occurred. Do you have experience dealing with the public? If so, please provide details. Please describe the type(s) of volunteer work you wish to perform (i.e. laundry, dishes, cleaning, dog walking, animal grooming, yard work, photography, etc.). What are your thoughts on spaying and neutering animals? This position will require you to be able to work mostly independently once trained, with some supervision. Do you have any concerns with working independently? Have you ever been found guilty of any violations pertaining to animal cruelty? If so, please describe. Do you have any questions for the Orange County Animal Shelter? Use this space to ask them. ReferencesBelow, please provide contact information for two personal references and one veterinary reference.Reference 1 Full Name Reference 1 Full Name First Name First Name Last Name Last Name Reference 1 Email Address Reference 1 Phone Number Reference 2 Full Name Reference 2 Full Name First Name First Name Last Name Last Name Reference 2 Email Address Reference 2 Phone Number Liability WaiverI, the Volunteer, desire to volunteer for Friends of Orange County Animal Shelter (FOCAS) and engage in activities related to being a volunteer. I understand that the activities may include, but are not limited to, all aspects of dog and cat-related care. I understand that working with and/or around animals with unknown and unpredictable characters and dispositions, as such, there is a risk to my person. I understand that I will be subjecting myself to various working conditions and activities, and I hereby assume the risk of any injury that may result from any of my volunteer activities. I hereby freely and voluntarily, without duress, and in consideration of the organization and support by FOCAS, execute this Release under the following terms:Waiver and Release. I, the Volunteer, on behalf of myself, my heirs, personal representatives and assigns, do hereby agree to waive and/or release any and all rights and claims that I, my executor, administrator, guardian, or my heirs, successors, and assigns may have against FOCAS arising from any damages, injury, or death that I might sustain during my volunteer activities with FOCAS. I further agree to indemnify and hold harmless FOCAS from any claims I might make, or that might be made on my behalf by others, or that might be made against me by others, arising from my volunteer activities with FOCAS, including, but not limited to, payment of FOCAS’s reasonable attorney’s fees and costs arising from any such claim.I, the Volunteer, understand that, except as otherwise agreed to by FOCAS in writing, FOCAS does not carry or maintain health, medical, or disability insurance coverage for any Volunteer. Each Volunteer is expected and encouraged to obtain his or her own medical or health insurance coverage.Photographic Release. I hereby grant to FOCAS irrevocable, perpetual right and permission to use my name, portrait, picture, image, appearance, and likeness (the “Publicity Rights”), for FOCAS’s business, commercial, advertising, and all social media or trade purposes (for example, use on FOCAS’s website). I hereby waive any right of attribution and any right to payment or an accounting from FOCAS relating to its use of the Publicity Rights, and I waive any right I may have to inspect or approve any use of the Publicity Rights. I hereby release FOCAS (and its employees and agents) from any claims I may have under Virginia Code § 8.01-40 or any other applicable law relating to the Publicity Rights, whether arising before or after the date hereof.I agree to comply with all the rules and regulations established by FOCAS, and I understand that failure to do so may result in my immediate termination as a volunteer. As a volunteer I agree to do my best to represent FOCAS to the public in an accurate and professional manner.I understand that if I am or become pregnant while volunteering at FOCAS or have a medical condition that compromises my immune system, I will speak to my doctor and obtain my doctor’s approval to volunteer with FOCAS.I, the Volunteer, expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Virginia and that this Release shall be governed by and interpreted in accordance with the laws of the Commonwealth of Virginia without regard for its choice of law provisions. Any action to enforce this Release shall be brought in any state or federal court located within the state of Virginia. Each party hereby consents to the jurisdiction of such courts to decide any and all such suits, actions, and proceedings and to such venue, and hereby expressly waives any right to a trial by jury in any and all such suits, actions, and proceedings.I, the Volunteer, understand and agree that this Release shall be binding on my successors, assigns,, and personal representatives. I, the Volunteer, agree that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of the Release, which shall continue to be enforceable.SignaturesBy checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternative manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. I agree Applicant's Signature * Date * Submit If you are human, leave this field blank.
