Volunteer Application Form
Name: ______________________________________ E-mail Address: ______________________________
Home Phone: ________________________________ Work Phone: _________________________________
Address: ________________________________________________________________________________
May we call you at work? __Yes __No
Please check your age group: ___10-17 ___18-30 ___31-50 ___51-65 ___65+
How did you learn about Hawaii Canines For Independence?
Please indicate the days and hours you are available for volunteer work:
Any additional comments about your schedule?
When can you begin volunteer work?
Please indicate the type of volunteer work you are interested in:
__ Puppy Raising(3-9months)
__ Dog Sitting(short-term)
__ Dog Grooming
__ Cleaning/Maintenance
__ Gardening
__ Dog Walking/Playing
__ Office Work
__ Fund Raising
__ PR/Marketing
__ Community Outreach
__ Special Occasions/Graduations
Please list any experience you have relating to the areas you checked:
How will your work with Hawaii Canines For Independence be of benefit to you?
How will your work with Hawaii Canines for Independence be of benefit to our agency?
Do you work best when you...
__ initiate and follow through by yourself (after sufficient training), or...
__ receive ongoing direction
If you are employed, please list your employers name, phone number and address:
_______________________________________________________________
Please list two personal references.
Name: _______________________ Name: _______________________
Phone: _______________________ Phone: ________________________
E-mail Address: _____________________ E-mail Address: ______________________
Volunteer Applicant Agreement
I declare that the above information is accurate. I will not hold Hawaii Canines for Independence liable for any injuries sustained while working for them. I understand that if I am injured while acting as an unpaid member of the volunteer staff I am not covered by Worker's Compensation Law.
________________________ _______________
Signature & Date