Volunteers are a very important part of Miranda's Rescue. We appreciate your interest in helping the animals in our care. Please fill out this form completely to help us get to know you and best match your interests and abilities with our available positions.

PERSONAL INFORMATION

Name:________________________________________________________

Address:_____________________________________________________

Phone (home):________________________________________________

Phone (work or cell):________________________________________

E-Mail:______________________________________________________

EMERGENCY CONTACT

Name:________________________________________________________

Phone(home):_________________________________________________

Phone(work or cell):_________________________________________

SKILLS, TRAINING, AND EXPERIENCE

Employer:____________________________________________________

Position:____________________________________________________

Do you have any special skills, training, or experience that 
apply to your volunteer work with us?






Do you have any physical limitations that we need to accommodate?
If so please describe:





DESIRED PROGRAMS (check all that apply)

(     )Dog walking	(     )Kennel and/or cage cleaning	(     )Grooming

(     )Special events   (     )Maintenance/Construction		(     )Fundraising

(     )Office/Clerical  (     )Other:_____________________________________________

DAYS/HOURS AVAILABLE
	 Monday	  Tuesday    Wednesday   Thursday   Friday   Saturday   Sunday

Hours:  _______   ________   ________    ________  ________  ________   _______
*volunteers wishing to work on a Sunday or Monday must receive special approval
from the director.

PERSONAL MOTIVATIONS AND EXPECTATIONS

Why do you want to volunteer at Miranda's Rescue?






RELEASE OF LIABILITY

Miranda's Rescue is an organization that cares for animals that come from many different backgrounds; some have been abused, neglected, or abandoned. While we take every precaution to ensure your safety on our premises, there is a chance that you may at some time become injured during the course of your volunteer work, either by an animal or through another type of accident. We ask our volunteers to use common sense around the animals--do not approach an animal unless you are absolutely sure that it is friendly, do not tease or antagonize any animals, and be aware of your surroundings at all times. Volunteers are required to sign the following affidavit:

I, ________________________________, agree to hold Miranda's Rescue
harmless for any injuries I receive on Miranda's Rescue property or
through the course of my volunteer work for Miranda's Rescue in other
locations.


Signed:________________________________________ Date:_______________


If under age 18:	Age:_____*

*All volunteers age 16 and younger must be accompanied by a parent or guardian or
make arrangements to be supervised by an experienced adult volunteer.

Parent's Printed Name:_______________________________________________

Parent's Signature:____________________________ Date:________________