Volunteer Profile. Between the ages of 10 and 17 you must be accompanied by an adult to volunteer at the shelter.

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1 Volunteer Profile Date: Thank you for your interest in our volunteer program. The Humane Society of Weld County offers a wide variety of opportunities that are designed to be both fun and rewarding. As a non-profit organization our volunteers are vital to the success of our daily operations. We depend on your generous donation of time and talent to provide quality care for our animals. Between the ages of 10 and 17 you must be accompanied by an adult to volunteer at the shelter. Please print your responses clearly. Last Name First Name MI Address City Zip Home Phone Cell Phone Date of Birth Address Emergency Contact Relation Contact Phone Alt Phone Please indicate the volunteer opportunities you are interested in: Y= yes N= no M= maybe: Working Directly with Animals Customer Service Veterinary Assistance Events/Planning Behavior Helpline Humane Education Admitting Animals into the Shelter Photography/Filming Foster Care Behavior Assessments Other: Are you able to make the required six month commitment? YES NO If no, why? Please indicate your availability: MON TUES WEDS THURS FRI SAT SUN Schedule Preference: Once a week Every other week Other Please indicate the animals you are comfortable handling: Y= yes N= no M= maybe A= allergies Small Dogs Large Dogs Cats Rabbits Ferrets *FLIP OVER*

2 Please indicate and special skills/talents you have: Clerical/Data Entry Photography Event Planning/Coordination Public Speaking Graphic Design Grant Research/Writing Writing/Editing Artist/Crafts Grooming Animal Behavior Training (please describe) Second Language (please list) Other (please describe) Do you have any pets? YES NO Are they spayed/neutered? YES NO If no, why? Have you ever been employed here? YES NO If yes, what position and when? Have you ever applied for employment here? YES NO If yes, what position and when? Are you presently employed? YES NO Employer Title Phone Number May we contact you at work? YES NO Do you have a valid driver s license? YES NO Excluding traffic violations, have you ever been convicted of any criminal offense? YES NO If yes, what were the charges? What was the outcome? What type of experience do you have working with animals? Describe any present or previous volunteer work you have done: _

3 Getting to Know You For each question we are simply trying to get a better sense of your personality to help you assess if our volunteer program is right for you. There is no right answer to any of these. 1. When you think of the Humane Society of Weld County, what s the first thing that comes to mind? 2. If you could describe yourself in three words, what would they be? 3. Do you prefer to spend your time with animals or people? Why? 4. Do you prefer a more fast-paced or laidback environment? Why? 5. How do you approach a situation when you don t know the proper procedure? 6. Imagine someone surrendering their pet to the shelter. How would that make you feel? 7. What are your feelings on spaying and neutering? 8. What are your feelings on euthanasia in shelters? *FLIP OVER*

4 9. What do you think would be most enjoyable when volunteering at a humane society? 10. What do you think would be most difficult when volunteering at a humane society? 11. What are your feelings about force-free training methods? (i.e. clicker training) 12. If you are under 18years old, who will be supervising your volunteer activities? (They must also submit a volunteer application) ESSENTIAL CAPABILITIES OF HSWC VOLUNTEER There are several animal care needs within the Humane Society of Weld County that are fulfilled by volunteers. To safely and effectively serve as a volunteer at the shelter, volunteers need to possess the following physical, mental and emotional capacities. The volunteer s signature on this form indicates he/she believes he/she possesses these basic capabilities. ESSENTIAL CAPABILITIES Quick reflexes and ability to use both hands simultaneously when working with animals (example: open a kennel door while handling an animal) Ability to walk unaided on unpaved, uneven, rugged and sometimes muddy and slippery ground when exercising dogs Ability to speak and communicate effectively Must not have a strong allergy to dogs, cats or other companion animals that cannot be managed by medication, or to chemicals used in cleaning Ability to cope with a very loud environment due to animal noises Ability to understand, remember and follow instructions and procedures Possess problem-solving capability Must be aware of potentially dangerous situations when working with the animals, must be able to remain calm with animals who are upset; behave sensitively and confidently; show good judgment and act appropriately in these situations Ability to cope with unexpected animal behavior without assistance Ability to cope with a highly emotionally charged environment with some animals that are homeless, abandoned and/or abused, as well as the reality that some of the animals in our care may be euthanized. Ability to understand the HSWC s policies and philosophies LEVEL OF SUPERVISION Once trained, must be able to work with minimal supervision, yet must recognize limitation in knowledge and abilities, and ask for help when needed Should be able to work independently for long periods of time, as well as work within a team atmosphere with other volunteers and staff OTHER A fairly high level of experience and familiarity with cats and dogs is desirable All animal care positions involve cleaning and the use of cleaning chemicals Please indicate any reasonable accommodation you may need in order to meet the essential capabilities of your volunteer position at HSWC. Volunteer signature Date Volunteer name (please print)

5 Waiver for Volunteers I, (your name), do participate as a volunteer at The Humane Society of Weld County solely as a volunteer. In my role as a volunteer, I do not represent any organization as an employee in any way, nor in any capacity. I wish to participate at The Humane Society of Weld County as a volunteer and I sign this Waiver and agree to each of the following: 1. I alone assume full responsibility for all my comments, my actions or voluntary assistance that I provide to the volunteer assignment, and hereby acknowledges that all comments, suggestions, ideas or help is made to the recipient only as a best guess or suggestion, which they should not follow unless they seek other professional assistance. Further, I understand that I am not to give medical advice to any patrons. 2. I release, waive, discharge and covenant not to make a claim against or to sue The Humane Society of Weld County or any of its employees, agents, officers, volunteers, or contractors from all liability for any recommendations, advice, suggestions or ideas which I may or may not have given to the projects, assignments or volunteer activities of The Humane Society of Weld County. 3. I recognize that in handling animals and performing other services, there exists a risk of injury including physical harm. On behalf of my heirs, personal representatives, executers, I release the Humane Society of Weld County, its agents, and employees from any and all claims, including the costs and attorneys fees incurred by the Humane Society of Weld County in connection with the same, based on damages or injuries which may be sustained by me during my services as a volunteer. This includes, but is not limited to, animal bites, accidents and injuries. 4. I agree to indemnify, save and hold harmless The Humane Society of Weld County and its employees from any and all loss, liability damage or cost that may be incurred due to any recommendations or work I participate in with my volunteer assignment(s). 5. I have read and am in agreement with the missions, goals, and services of the Humane Society of Weld County. I will abide by the Volunteer Handbook guidelines. 6. I will familiarize myself with and comply with the Humane Society of Weld County s policies, procedures, safety and sanitation protocol. 7. I hereby grant the Humane Society of Weld County to use photographs taken of myself during service and to publish such photos (still photos or film/video) as they see fit and I waive any rights and claims I may make regarding the taking or publishing of any such photos. 8. I grant permission to the Humane Society of Weld County to reproduce any photos I take of the Humane Society of Weld County animals, events and property. 9. I attest that I have made no oral representations, statements, or inducements apart from the foregoing written agreement have been made. 10. I agree to read and voluntarily sign this Release, Waiver and Indemnity Agreement. Volunteer signature Date Volunteer name (please print) Release for Minors I,, being the parent or legal guardian of give my consent to allow my (son, daughter or ward) to perform volunteer services for the Humane Society of Weld County. I fully understand and acknowledge that his/her services are to perform subject to all the rules and regulations of the Humane Society of Weld County. All services preformed by my son/daughter/ward are strictly voluntary, without pay or compensation of any sort and without liability of any nature on behalf of the Humane Society of Weld County. I further that all services are performed at his/her own risk. On behalf of myself, my (son, daughter or ward) my heirs, personal representatives or administrators, I hereby release and hold harmless the Humane Society of Weld County, its agents and employees from any and all claims incurred by the Humane Society of Weld County, including but not limited to animal bites, accidents and injuries. Parent or Legal Guardian Signature Date