Humane Society of Southwestern Michigan
KID VOLUNTEER APPLICATION
Adobe
Acrobat version
(Click
here if you do not have adobe)
Kid
Volunteer Application (Please Print Neatly)
Humane Society of Southwestern Michigan
641 S. Crystal Ave. Benton Harbor MI 49022
269-927-3303
NAME: _______________________________
ADDRESS: ___________________________
CITY: _______________ STATE: _________ ZIP: _____________
HOME PHONE: ______________ EMAIL: _______________
AGE: ___ CURRENT GRADE IN SCHOOL: __ SCHOOL NAME: ______________
IS YOUR VOLUNTEER WORK A SCHOOL REQUIREMENT: ________________
IF
SO HOW MANY HOURS MUST YOU COMPLETE: ______________________
WHY DO YOU WANT TO VOLUNTEER HERE? ________________
PARENT OR GUARDIANS NAME: ______________________
DO YOU HAVE ANY ALLERGY’S WE SHOULD KNOW ABOUT: ____________
DO YOU HAVE TRANSPORTATION TO & FROM THE SHELTER? _________
DO YOU OWN ANIMALS? ______WHAT KINDS?__________________________
DO YOU HAVE ANY FEARS WE SHOULD KNOW ABOUT? ________________
WHAT IS YOUR FAVORITE TYPE OF PET? ______________________________
HOW MUCH TIME DO YOU PLAN ON VOLUNTEERING EACH MONTH?
HUMANE SOCIETY OF SOUTHWESTERN MICHIGAN
KID VOLUNTEER PERMISSION SLIP & LIABILITY WAIVER
I, _____________________________ the parent of _________________________ do hereby give permission for my minor child to participate in the Humane Society of Southwestern Michigan’s kid volunteer program. I understand that my child will be working with and around animals and may be asked to do physical labor such as sweeping, mopping, cleaning, and will be walking dogs and handling cats and kittens & puppies. I hereby knowingly, freely, and voluntarily waive any right or cause of action of any kind whatsoever arising as a result of such activity from which and liability may or could accrue against the Humane Society of Southwestern Michigan or its agents or employees jointly or individually.
I fully recognize the possible dangers associated with the work of the Humane society of southwestern Michigan and I understand that the shelter and its staff will make every effort to provide a safe environment for your child.
PARENTS
SIGNATURE: ________________________________DATE:__________
WITNESSED BY: ______________________________________ DATE:__________
EMERGENCY
CONTACT INFORMATION:
In case of emergency notify : ________________________________________
Relationship: _______________________home phone: ____________________
Work phone: ________________________cell phone: _____________________
Secondary contact: __________________________________________________
Relationship: __________________ home phone: ________________________
Work phone: ___________________ cell phone: _________________________
PHYSICIAN: ______________________________phone: _____________________
Does
your child have any allergies or physical limitations? ________________________________________________________________________
Does your child have any fears of animals that we should know?
HUMANE SOCIETY OF SOUTHWESTERN MICHIGAN PARENT INFORMATION SHEET
641 S. Crystal Ave.
Benton Harbor MI 49022
269-927-3303
HOURS: mon, thur, & fri 11am-5pm
Wed 11-7pm
Saturday 10am-1pm
Closed tues & Sunday
Because we, as well as you, consider your child a precious commodity we want to ensure the absolute safety of your child while they are in our care. We welcome parents or guardians who want to work with their child during their volunteer time to help build a parent – child relationship. This is not required however. Child volunteers must be 12 years of age or older to volunteer at the shelter. Younger children can volunteer if accompanied by a parent or guardian starting at age 9.
For your child’s protection we ask that when dropping off and picking up your child you check in with the front desk and let us know you are taking your child. We understand that sometimes in this day and age non-custodial parents or relatives may attempt to pick your child up without consent and we wish to protect your child in every way. Children will not be allowed to leave the shelter without an adult coming inside and getting them. If at any time you have questions about our volunteer program feel free to call the volunteer coordinator, sue Burkhard at 927-3303 or on her cell phone at 369-3151.
Thank you
Humane
society of southwestern Michigan
Kid volunteer job list
Please check the areas that most interest you.
ANIMAL CARE SPECIALIST: Animal care volunteers keep the animals
in the shelter appealing to the public by bathing, brushing, and
combing the animals. They may also trim toe nails, clean ears,
and make animals appear attractive and clean for potential adopters.
Volunteers in this area increase the animal’s chance of adoption
by keeping them cared for and looking their best.
I
would be interested in this position: ______
DOG WALKER: Dog walkers come in and walk dogs that are available
for adoption, providing them with a much needed outlet for their
excess energy. Walkers also work with the dogs teaching them how
to walk nicely on a lead and teaching them manners. Many dogs
that come into the shelter have never been taught any obedience.
By teaching them basic good behavior you increase their chances
of adoption immensely.
I would be interested in this position: ______
GROUNDS KEEPER/LANDSCAPER: Do you have a green thumb? Do you like
to work in the great outdoors? The shelter sits on a large piece
of land that needs to be maintained and kept looking nice. Some
of the opportunities here would include planting and caring for
flowers, trimming brush and trees, maintaining outside structures,
picking
up debris and trash in the yard. In this field you help the shelter animals by making the shelter more attractive to customers and visitors, and helping to promote a positive attitude for the employees who come to work seeing a nice, clean, cheerful environment.
I would be interested in this position: ______
SPECIAL EVENTS/INFORMATION BOOTH ATTENDANT: Throughout the year the shelter has the opportunity to have an information booth at various community events. Volunteers are needed to staff the booth and answer questions, pass out information on various topics, and develop a rapport with the public about the Humane Society. By working community booths, volunteers help the animals by promoting the organization, informing the public about our shelter and the programs and services we provide. They also help to reduce the number of animals brought into the shelter by educating the public about the importance of pet responsibility and care.
I would be interested in this position: ______
PRODUCTION ASSISTANT: The Humane Society staff depends on multiple documents daily, which need to be copied, collated, stapled, and such. Production volunteers help with these tasks, along with other as needed office projects. This enables the staff to take care of other vital administrative tasks and waiting on customers, which ultimately makes customers experiences more positive, helping the animals be viewed in a better light.
I would be interested in this position: _____
CRAFTER: This is a volunteer opportunity that can be done from
home. If you can’t or do not want to spend time at the shelter
but still want to help the animals here is an opportunity for
you. “Wubbie Makers” knit, sew, or crochet cat kennel
sized blankets for our kitties to snuggle with. Not only does
this give the kitties something to snuggle and play with, it provides
warmth from drafts and sometimes a hiding place for a shy kitty.
Toy Makers can make a variety of cat toys for the cats to play
with and also for us to sell to raise much needed money for our
animals and Spay Neuter Assistance Program. Material and Catnip
can be provided if needed for this program. Other craft items
can be made for us to sale at various functions and in our “Boutique
Corner” at the shelter to raise money for our critters.
I
would be interested in this position: ______
back
to previous page
This
is the Official Web Site of Humane Society of Southwestern Michigan
