Volunteer Application Form
Box 2126 Hanna, AB T0J 1P0 Ph: (403)854-3700 Email: info@hannaspca.com or hannaspca.com
Please Print Clearly:
Date: ____________________
First Name: ______________________ Last Name: __________________________________
Address: Box # ___________________ City/Province: ________________________________
Home/Cell Phone: _________________________ Work Phone: _________________________
Email: ______________________________________________
Emergency Contact: ____________________________________
Home/Cell Phone: _________________________ Work Phone: ________________________
Do you have any medical conditions that could be aggravated by exposure to high concentration of animals? Yes ___ No ___
If yes, specify: ________________________________________________________________
____________________________________________________________________________
Do you belong to any other animal clubs/organizations/non-profit organizations? Yes __ No__
Specify: ______________________________________________________________________
Do you have any pets? Yes __ No__
If yes, specify: _______________________________________________________________
___________________________________________________________________________
Are your pets adopted from the Hanna SPCA? Yes __ No__
If yes, specify: ______________________________________________________________
Why are you interested in volunteering for the Hanna SPCA?
____________________________________________________________________________
____________________________________________________________________________
Do you have any skills/training that you are willing to utilize for the Hanna SPCA (i.e. animal training skills, computer knowledge, artistic, salesmanship, media relations, etc.)? Yes __ No__
If yes please provide information: ________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Are you a member of the Hanna SPCA? Yes__ No__
If not, are you interested in becoming one? Yes__ No__
What days of the week are you available to volunteer? Check all that apply:
Monday ___ Morning ____ Afternoon ____ Evening ____
Tuesday ___ Morning ____ Afternoon ____ Evening ____
Wednesday ___ Morning ____ Afternoon ____ Evening ____
Thursday ___ Morning ____ Afternoon ____ Evening ____
Friday ___ Morning ____ Afternoon ____ Evening ____
Saturday ___ Morning ____ Afternoon ____ Evening ____
Sunday ___ Morning ____ Afternoon ____ Evening ____
RELEASE AND INDEMNITY
OF THE
HANNA S.P.C.A.
(Hereinafter known as the Society)
The undersigned, in acting as a Volunteer for the Society, hereby releases the Society, its agents, officers, and servants of and from any and all liability, claims, demands, actions and causes of actions, whatsoever out of or relating to any loss, damage or injury that may be sustained by the undersigned or any of the property of the undersigned.
The undersigned hereby acknowledges the risk inherent in the handling of animals, domesticated or wild, and hereby willingly accepts all such risks.
This Release and Indemnity shall be binding upon the undersigned’s his/her heirs, executors, administrators they assign.
Dated the ___________________ day of _________________ A.D. 20_________
Name (Print): _______________________________________________________
Address: Box #: _____________ Street #:________________________________________________________
City/Town: ____________________________ Province: ____________ Postal Code: ____________________
Phone #: ______________________________ Cell #: _____________________________
Volunteer Signature: ________________________________________________________________________
This document to be signed by all persons volunteering for the Society.
The information on this application is strictly confidential and will not be shared with anyone outside of the Hanna and District S.P.C.A. unless permission is granted by the applicant.
Please drop off completed form at:
321 - 3rd Avenue East Hanna, Alberta
Mail to: Hanna S.P.C.A. Box 2126 Hanna, Alberta T0J 1P0 Email: info@hannaspca.com
