Volunteer Application Step 1 of 2 50% Name* First Last Select ALL categories of interest to you* Dog Walker Cat Cuddler Equine Center PetSmart Cat Adoption Center YHS Thrift Store Spay/Neuter Clinic Administrative/Data Entry Fundraising/Special Events Offsite Events Shelter Care (Maintenance, Landscaping, Etc.) Education Presentations/Shelter Guide Skills* Dog Training Equine Experience Handyman Fundraising Typing/Data Entry Marketing Computer Savvy Administration Public Speaking Customer Service Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country A phone interview and a review of references is required before an orientation is scheduled. This is a standard Yavapai Humane Society procedure to insure that our organization is the right fit for you!* You may call me for an interview Phone*Email* Emergency Contact InformationEmergency Contact Name* First Last Emergency Contact Phone*Volunteer InformationI want to volunteer:* because I enjoy helping homeless pets to fulfill court-ordered community service for a school project other please check all which applyIf other please describe I am 18 or older* Yes No Date of Birth* MM slash DD slash YYYY Other skills:Please list two references complete with name, phone number and relationship:* Statement of Agreement*Please read each statement, check the box and indicate agreement by your signature below. I agree not to consume, use, possess or be under the influence of any drug or alcohol products while volunteering for Yavapai Humane Society. I understand that any conduct or pattern of conduct that would tend to disrupt, diminish or otherwise jeopardize public trust in Yavapai Humane Society will result in dismissal. I understand that my volunteer assignment with Yavapai Humane Society may be terminated at any time. I have NOT been convicted and/or placed on probation for any criminal offense. Record*If you have been convicted of a crime and/or placed on probation, please list date and nature of the offense: I understand that depending upon the nature of the volunteer assignment, Yavapai Humane Society may deem it necessary to obtain a Driver’s License Record, Sex Offender Record, and/or a Criminal Conviction History and Wanted Information Reports on individuals volunteering for Yavapai Humane Society. YAVAPAI HUMANE SOCIETY (YHS) AGREEMENT OF WAIVER OF LIABILITY & HOLD HARMLESS AGREEMENT*I hereby agree to accept a position as a volunteer worker with YHS, and in doing so, I agree to comply with all the rules and regulations established by YHS, and I understand that failure to do so may result in my immediate termination as a volunteer. As a volunteer, I agree to do my best to represent the Yavapai Humane Society in an accurate, friendly, and professional manner. Volunteers may be entrusted with sensitive and confidential information while volunteering. Information relating to YHS employees, volunteers, customers, and donors is confidential. I agree that I will not disclose or make any use of such confidential information. I agree to accept such appointment subject to receiving the training provided by YHS and understand that my participation is purely voluntary, without compensation. Participation may be withdrawn or denied for any reason without cause. I understand that public relations are an important part of volunteering at Yavapai Humane Society. On behalf of myself, my heirs, personal representatives, and executors, I hereby allow the Yavapai Humane Society to use any photographs taken of me for use in public relation efforts. By signing this agreement I agree not to sue, and to release, waive, discharge and hold harmless the Yavapai Humane Society and all their directors, agents, and employees from any, and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me while participating in any volunteer activity on behalf of the Yavapai Humane Society, or in transportation to and from any volunteer activity of the Yavapai Humane Society. PhoneThis field is for validation purposes and should be left unchanged.