New Volunteer Application

Date_________________ Name___________________________Nickname___________________

Address__________________________________________________________________________

City_________________________________ State__________ Zip _______________-________

Home Phone ______________________________ Fax __________________________________

Work Phone ______________________________ e-Mail ________________________________

How did you hear about GHS _______________________________________________________

Special Skills you could contribute to GHS? ___________________________________________ _____________________________________________________________________________

What prompts you to want to volunteer with GHS? _______________________________________ _____________________________________________________________________________

Indicate below your area of preference for volunteering:

____ Adoption Days/Placement

____ Education Committee

____Fundraising

____ Foster Home

____ Newsletter/Newsletter Distribution

____ Pat-A-Pet Program

____ Phone Lines

____ Prevent-A-Litter campaign (annual)

____ Special Events (community appearances)

____ Publications

Do you wish to volunteer on a routine (weekly, monthly) basis? ______________________________

Number of hours you would like to volunteer with GHS _________________/ __________________

Are you required to complete a certain amount of volunteer hours for a school, church, or other organization?______________________ If so, how many hours?____________________________

Please list the names of any friends or relatives working or volunteering with GHS. Also list their relationship to you. ______________________________________________ ________________________________________________________________________

Do you have any physical or mental limitations that may hinder you from participating in any part of the program? Yes______No______ If Yes please explain _____________________________________ ______________________________________________________________________________

Please list any Illnesses, Allergies, or Disabilities that may hinder you? (ie. Heart condition, diabetes, back injuries, epilepsy). ________________________________________________________________ ______________________________________________________________________________

What is your experience with Animal Care, Training, and Handling?___________________________ ______________________________________________________________________________ ______________________________________________________________________________

What pets do you currently have in your home? (Name, type, age) ____________________________ ______________________________________________________________________________ ______________________________________________________________________________

Where do your pets live? __________________________________________________________

Are your pets spayed/neutered? _____________________________________________________

What happened to your past pets? ___________________________________________________

Can you provide a foster home for a dog ____________________or a cat ____________________

Where would the foster animal stay? _________________________________________________

Please explain your philosophies regarding the following areas:

Have you ever adopted an animal from this group or another rescue group or shelter? ______________

If so, from whom? _________________When?___________________________________________

In case of emergency:

Notify _____________________________________ Phone ________________________________

Signature ________________________________________________________________________

Under 19 years old, Guardian Signature _________________________________________________

If you are under 19 years of age your parent is required to volunteer with you. Please reference our Junior Volunteer Policies and Requirements. Thank you for your interest in volunteering.

Please return your completed application to:

Gwinnett Humane Society
Volunteer Coordinator
P.O. Box 750 Lawrenceville, GA 30046

770-798-7711 Line 6
volunteer@gwinnetthumane.com