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South Plains SPCA Volunteer Application
2012 
Form 2
–
Version March 30, 2012 Page 1
Note: Please fill out application completely. Any unchecked or blank spaces will mean your application will not be given full consideration. Thank you.
Name
:_______________________________________________ 
Phone Number
:________________________________ 
Address:
 __________________________________ 
City
:___________________ 
State
:______ 
Zip
:_________ 
Email
:___________________________________ 
DL Number
:___________________ 
State
:_____ 
Age
:_______ 
DOB
:___________________ 
Emergency Contact
: _____________________________________ 
Emergency Contact Phone Number
: ___________________________ 
Do you have any physical limitations, allergies or health concerns that will affect your volunteer work?No Yes If yes
 –
please explain:
I am interested in
: _____ Adoptions (Petsmart, Shelters, Off Site) _____ Transporting _____ Fundraising _____ Daily Duties (clean cages, socialize animals, etc.) _____ Other: _____________________________________________________________________________ 
 
Do you volunteer/foster for another rescue organization: Yes NoIf yes which one: ________________________________________________________________
 
South Plains SPCA Volunteer Application
2012 
Form 2
–
Version March 30, 2012 Page 2
Please provide 3 references:1.
Name: _____________________________________ Phone Number: _______________________________ Email: _______________________________________ 
2.
Name: _____________________________________ Phone Number: _______________________________ Email: _______________________________________ 
3.
Name: _____________________________________ Phone Number: _______________________________ Email: _______________________________________ 
 
As a volunteer with the South Plains SCPA, I agree to the following terms and conditions:
 
My services to the SPSPCA are provided strictly in a voluntary capacity and without anyexpressed or implied promise of salary, compensation or other payment of any kindwhatsoever.
 
My services are furnished without any employment benefits, including employment insurance
programs, worker’s compensation accrual in any form, vacations or sick time.
 
I ________ (initials) will familiarize myself and comply with the SPSPCA policies and proceduresapplicable to volunteers. SPSPCA expects high standards of moral and ethical treatment of theanimals under its care. I will adhere strictly to these standards. I will follow the policies,procedures and safety precautions of SPSPCA and follow the instructions/directions of
directors’ and staff.
 
 
I ________ (initials) understand that SPSPCA, without notice or hearing, may terminate myvolunteer services as a volunteer at any time, with or without reason.
 
I understand the potential safety risks of working with animals and bringing home illnesseswithin the SPSPCA foster system to personal pets. I will practice sound health hygiene andadhere to the hygiene policies of SPSPCA. I am covered by a health insurance plan and I amcurrent on my tetanus vaccine.
 
If I am ________ (initials) caught stealing from the SPSPCA, I understand that I will beprosecuted to the fullest extent.
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