Volunteer Application

Name:   Email Address:   Street Address: City:   State:   Zip Code: Home Phone: (enter numbers only) Work Phone: (enter numbers only) Cell Phone: (enter numbers only) Age: Date Of Birth: (dd/mm/yyyy)   Place of Employment: Why do you want to volunteer for Project HALO? How did you hear about the volunteer program? Do you have any specific skills that would be beneficial to Project HALO? Please check the volunteer positions you are interested in: Administrative Support Foster Care Grooming Disaster Relief field work Pet-Facilitated Therapy Adoption Days Humane Education Transport for disaster areas Animal care Special Events/Fundraising News Media/ PR Picture Taker How many hours can you commit per week? Please specify available days and times.   Would you be interested in becoming a volunteer supervisor? Yes Does your organization participate in charitable gift matching program? Yes Do you know a local business or individual who might be willing to donate services or become a sponsor of the Project HALO? Are you pregnant, afraid of, or allergic to animals? Have an immune system deficiency, or had your spleen removed? If so, please explain. Yes Do you have any physical or emotional conditions that might hinder your volunteer service or require us to provide you with extra assistance or supervision? If so, please explain. Yes Have you ever been convicted of a felony? If so, please explain. Yes

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