Volunteer Form

Canine Companions Volunteer Application

Name: ______________________________________ D.O.B.______ Gender: M ____ F ____

Address: _________________________________________________ Apt #: _________

City: ______________________________________ State: __________ Zip: _________

Phone #: ____________ Alt Phone #: _____________ Email: ______________________

If you are under 18, we must have written consent by a parent or guardian.

Currently employed? Y ____ N _____ Average # of hours worked a week:_________

What day(s) works best for you? (Check all that apply)

____ Sun ____ Mon ____ Tue ____Wed ____ Thu ____ Fri ____ Sat

What time of the day works best for you? (Check all that apply)

Morning _______ Afternoon _______ Evening _______

Hours per day / week / month are you willing to volunteer? Please be as specific as possible.

______________________________________________________

______________________________________________________________________________________

Reason for volunteering: ______________________________________________________

______________________________________________________________________________________

Please check the area in which you are willing to donate you time. (Check all that apply)

____ Social / play time ____ Bathing & brushing ____ Walking/Exercising ____ Potty Monitor and Clean Up

____ Training Assistant

Are you a pet owner currently or in the past? If so, what breed(s)? _______________________________________

Volunteer Signiture:__________________________________________ Date:_________________

(Parent or Guardian signiture if under 18 years of age)

Canine Companions :__________________________________________ Date:_________________

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