Name________________________________________________________________



Date of Application___________________ Date of Birth________________



Street Address______________________________________________________



City_____________________ State____________________ Zip_____________



Home Phone_______________________ Work Phone________________________

					(if we may contact you there)



Occupation__________________________________________________________



Experience or skills that you would be willing to share with us:



_____________________________________________________________________



_____________________________________________________________________



What type of volunteer jobs are you interested in? (please check)



___telephone			___animal bathing/grooming

___special events		___newsletter

___public relations		___photography

___typing/office skills		___illustrative/artistic

___humane education		___animal socialization

___mailings			___computer

___foster parenting		___maintenance

___yard/lawn care		___dog walker

___other (identify)



Times available to work:	___Day  ___Evening  ___Weekend



In case of emergency, notify_________________________________________



Address______________________________________________________________



_____________________________________________________________________



Relationship___________________________ Home Phone___________________



					Work Phone___________________



Additional comments/suggestions______________________________________



_____________________________________________________________________