Volunteer Request Form

Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone *

Area Code Phone Number

E-mail *

Birth Date *

Month Day Year

Must have parent signature at bottom of form if under the age of 18

Emergency Contact: Name, Relationship, Phone Number *

Reference personal or professional that can speak on behalf of you, and your work/experience/interest in helping animals. Please list name and phone number / email address. (If no number or email address is listed we will not be able to process your application)

Area you would like to volunteer check all that apply *

dog fostering (all animals in home must be spayed/neutered, must have fenced in yard, must have ability to get dog to vet (upon approval of RCAPS) /shelter/transport when needed, must live within 30 min of Henderson, NC this may include bottle feeding if you check fostering please let us know in the other section below if you are or are not willing to bottle feed cat fostering (all animals in the home must be spayed/neutered, must have ability to get cat to vet (upon approval of RCAPS) /shelter/transport when needed, must live within 30 min of Henderson, NC) this may include bottle feeding if you check fostering please let us know in the other section below if you are or are not willing to bottle feed transporting animals fundraising taking pictures (pictures cannot be copyrighted and can be used or altered for any purpose by anyone) updating facebook page, website, emailing contacting rescues other

If checked other explain here:

A lot of the volunteering done for our group is done via Facebook and the computer. Please give us the link to your Facebook page (if you are under the age of 13 please give us your parents Facebook page as they will need to find the best fit for you) and let us know how much time per week you are looking to volunteer. Also let us know what days and hours you are available either to volunteer on the computer or in person. *

How many animals do you own? *

Are all the animals in your home spayed or neutered? *

If you are applying to foster please list name and number of current vet. If you are not applying to foster write not fostering in the box. *

List any and all allergies *

Have you ever surrendered an animal to a shelter or rescue group? *

If yes to above question please explain.

Have you ever been or are you still part of animal breeding?

Please list all prior experience working with animals and/or any special skills: *

List any special needs you would have in respect to performing volunteer duties.: *

Please explain how you heard about our group and why you want to volunteer with RCAPS? *

Have you ever been convicted of a crime?

If yes to above please explain.

Upon becoming approved to volunteer with RCAPS you become a representative of RCAPS and its members. When acting as an RCAPS representative it is excpected that you will act in a mature and responisible way. As an RCAPS volunteer you will refrain from public criticism of participants or other volunteers. RCAPS representatives will refrain from the use of profane, insulting, harassing or otherwise offensive language while volunteering. RCAPS believes that all animals deserve to live and be given the chance to live. RCAPS believes that no healthy animal under any circumstances should be put down / killed. RCAPS believes that no animal should EVER be surrendered to a kill shelter. RCAPS believes that there are no reasons to breed cats/dogs and people should adopt not shop. RCAPS does not do adoptions (unless under extentuating circumstances) and is not a rescue group. RCAPS does its best to find rescue groups that can help the animals at our local Vance County Shelter. We offer free transport to approved rescue groups (have filled out our rescue application and have been approved) from NC-NJ. RCAPS is not completley a volunteer orginization but depends very much on volunteers to operate. RCAPS is 501c3 approved which means all donations are tax deductible.

Liability Waiver

By submitting this form I herby agree to indemnify and hold harmless the Ruin Creek Animal Protection Society of Henderson, it’s agents, Board of Directors, and the County of Vance from any and all liability arising of or in consequence of, or injury sustained as a result of any activity connected with myself or my child(ren) volunteering for Ruin Creek Animal Protection Society of Henderson.

By submitting this form I am stating that I have not been convicted of possession and/or intent to sell any illegal drugs nor have I been convicted of assault, abuse, neglect and or battery towards an animal or person. I am aware that the North Carolina Court site will be access to determine my eligibility.

Consent for Minor

By submitting this form I am agreeing that I am 18 years of age or older or have parental consent to volunteer for Ruin Creek Animal Protection Society of Henderson. If under age 18 I understand that I must have parent/guardian/responsible adult with me at all times while volunteering. RCAPS volunteers will not be responsible for or supervising children under 18. All parents/guardians/responsible adults supervising minor volunteers must sign this form and fill out their own application.

Please allow 2-3 weeks for your application to be processed. Thank You.

By signing and submitting below you are stating that you have read and agree with all items above.

Signature

Volunteer Form