First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Cell Phone*

What is your date of birth? (mm/dd/yyyy)*

In the case of an emergency, who can we contact? We need the first name, last name, and best phone number.*

Who is someone we can contact for a reference? (First and last name, phone number, and e-mail address)*

What is your general availability? Please provide general times of day as well as days of the week. This will help the volunteer coordinator but they will also discuss during orientation.*

Are you a student needing volunteer hours?*
Choose one: Yes No

What volunteer activities are you interested in performing? (Check all that apply) NOTE: if you are looking to foster, there is a form specific to that

Preferred Volunteer Location (check all that apply)

Are you proficient in any languages other than English? We ask because you may be able to assist if we get inquiries where someone's preferred language is not English.

How did you hear about R.A.I.N.?*

Why do you want to become a R.A.I.N. volunteer?*

Do you currently have pets?*
Choose one: Yes No

Describe any previous education, training or work experience with animals.*

By submitting this form, you agree to accept a position as a volunteer for R.A.I.N. In doing so, you agree to comply with all of the rules, regulations, policies, and procedures of R.A.I.N. You understand that failure to do so may result in immediate termination as a volunteer. You acknowledge that your services are provided strictly on a volunteer basis, without pay or compensation of any kind. You recognize that in the performance of volunteer tasks there exists a risk of injury including, but not limited to, physical harm caused by animals. On behalf of yourself, your heirs, personal representatives and executors, you hereby release, discharge, indemnify and hold harmless, R.A.I.N, its agents, servants, and employees from any and all claims, causes of action, or demands, of any nature or cause, including all claims arising out of the negligence of any persons for whose actions R.A.I.N. may be held liable, and including attorney fees incurred or sustained by you in any way connected with your services for R.A.I.N., including but not limited to animal bites, accidents or injuries. Type your full name and date (including year) of this form submission below if you agree to the above.*