Jazzpurr Society for Animal Protection


The information on this form will help us to find the most satisfying and appropriate volunteer service for you. Your cooperation in completing it, is most appreciated. All information will be held in confidence.


Last Name    First Name    Middle Name  

Phone (H)       Phone (W)   FAX 

Street Address 

City (Town)       Prov (State)   

Postal (Zip) Code        E-Mail 

(Optional) Date of Birth      S.I.N. 

Contact in case of Emergency      

Phone 

I.  EDUCATION, TRAINING, EXPERIENCE, SKILLS AND INTERESTS
                        Education:  Please tell us about your formal educational background:
                      

                         Informal Training/ Courses: (Arts, crafts, animal care, flying airplanes, etc)
                      

                        Current Occupation:
                     

                         Previous Occupation (s):
                      

Volunteer Experience:
                     Are you presently volunteering for another organization? yes No
                     Name of Organization: 
                         Duties/Accomplishments:

                      Have you volunteered for other organizations? yes No
                      Name of Organization: 
                         Duties/Accomplishments:

                      Name of Organization: 
                         Duties/Accomplishments:

Special Skills, Interests, Hobbies:
   Animal Care:       

   Computer:            

   Writing/Teaching: 

   Organizational:      

   Other:                     

Please check all jobs of interest to you:
Cat Care Giver
Adoptions
Clinical Coordination Assistant
Clinical Assistant
Counselor
Librarian
Kids' Day Camp Facilitator
Cat Care Teacher
Writer
Desk-Top Publisher
Web Wizard
Animal Assisted Therapist
Board of Directors
Committee Chair/Member
General Office Work
Reception
Bookkeeping
Membership Secretary
Grant Writing
Donation Cans
Grocery Store Tapes
Phonathons/Mail Campaigns
Special Events
Special Projects


Is there anything else that you wish to tell us about yourself?

   

II.  AVAILABILITY
How many hours per week can you contribute (generally, at least four):

What time slots?  

Do you have access to a car that you can use for volunteer work?   Yes No
III.  REFERENCES
How did you hear about us?  

Please give us the names and telephone numbers of two references:

1)  A personal reference:
Name:    Relationship to you:     

Phone:

2)  A professional reference (employer, supervisor, counselor, project or team leader)
Name:    Relationship to you:    

Phone:

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and mail or fax it to us.