NCCR Volunteer Application

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Thank you for your interest in volunteering with Northern Chautauqua Canine Rescue! Once you have filled out the form (you must be over 18 years of age) we will contact you to set up a time to come in for volunteer training!

Email *

Name *

Date of Birth: *

Address: *

Phone: *

The date of your last tetanus shot:
*

Emergency contact name and phone number: *

If employed, please provide employer name: *

Activities that interest you: *

Walking and playing with dogs

Bathing and grooming dogs

Shelter tasks (feed, clean, general care)

Best Friend Program-working specifically with one designated dog

Special Events (fundraisers, festivals, adoption days, lawn sale, etc.)

Facility maintenance and repair

Veterinarian Runs (Fredonia and Westfield)

Required

Hours available for volunteering 8:30-11 a.m., 1-3:30 p.m. and 6-8 p.m. List days/times you would like to volunteer. *

How did you hear about the NCCR Volunteer Program? *

Why are you interested in becoming an NCCR Volunteer? *

Describe any previous experience working with animals. *

Do you currently have any pets? Tell us a little about them! *

Were you ever or are you now actively involved with any other non-profit or community organizations? If so, please list: *

Do you have any allergies or physical restrictions that may prevent you from certain activities? *

Are there any size or breed of dogs that you are uncomfortable working with? *

Excluding traffic violations, have you ever been convicted of any criminal offense? If yes, please explain: *

Please list two references including their phone numbers and relationship to you. *

I give permission to NCCR to verify any information given above. Type name and date. *

Waiver of Responsibility I intend to participate in the volunteer program at Northern Chautauqua Canine Rescue, Inc. and am doing so entirely of my own initiative, risk and responsibility. I understand that as a volunteer, I will be working with dogs with unknown and unpredictable dispositions. Therefore, in consideration of the permission extended by Northern Chautauqua Canine Rescue, Inc., through its officers and agents, I hereby for myself, my heirs, executors and administrators, remise, release and discharge Northern Chautauqua Canine Rescue, Inc., its officers and employees from all claims, demands, actions or causes of actions, on account of any injury or illness to me which may occur during my volunteer services. Type Name and Date below: *

Northern Chautauqua Canine Rescue, Inc. reserves the right to decline any volunteer application for any reason.

A copy of your responses will be emailed to the address you provided.

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