PALS Volunteer Application

1. Please provide the following personal information:

Mr. Mrs. Miss Ms.

2. Employer:

3. Occupation:

4. Age Group: 16-18 19-30 31-45 46-65 66+

5. In case of emergency, contact:

6. How did you hear about PALS?

7. Why are you interested in becoming a PALS volunteer?

8. Please indicate the areas you would be interested in volunteering
(check ALL that apply):

9. Please detail your experience in the volunteer areas chosen:

10. Days you are available: (No Pet Visits on Fridays)

11. Times you are available:

12. Is there any day/time you are absolutely NOT available?

13. Have you had any experience as a volunteer, in a paid position,
or otherwise working with:

If YES, please provide details:

14. Please select areas of experience you have with animals:

15. Please provide details of your experience:

16. Do you have any physical or medical limitations which may limit the extent of your participation in PALS?

Yes No

If YES, please provide details:

17. Please describe any hobbies, skills, interests or languages spoken that you would like us to know about:

18. Do you have your own transportation? Yes No

19. Is there any additional information you would like us to know?

Please provide infomation about three references we may contact
(exclude immediate family):

Reference 1:

Reference 2:

Reference 3: