Name* Mr.Mrs.MissMs.Dr.Prof.Rev.Mx.None Prefix First Last What are your pronouns? She/her/hers He/him/his They/them/theirs Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Land LineCell PhoneAt which CHS location do you want to volunteer?*NewingtonWaterfordWestportDid you watch the volunteer virtual open house presentation? (This is a requirement to apply.)* Yes No What was the code word at the end of the presentation?* Are you 18 or older?* Yes No Do you have active health insurance?* Yes No Are you ready to commit to at least 6 consecutive months of service?* Yes No Do you understand that CHS practices limited euthanasia for medical and behavioral reasons, and will you be understanding and respectful of these decisions?* Yes No Are you ready to be an outstanding volunteer?* Yes No Do you have reliable transportation?* Yes No What hours, between 8:00 am - 5:30 pm, are you available to work?*What days of the week would you like to volunteer? Check all that apply.* Sunday Monday Tuesday Wednesday Thursday Friday Saturday Are you available the same day and time each week for a regular shift?* Yes No Are you able to work independently with limited supervision or will you require support from a trained parent or guardian?*I can work independentlyI will require support from a parent or guardian.What offence have you been accused and/or convicted of, or pled guilty to? (Court documentation to verify is required.)* How many service hours must you complete? (We only accept volunteers with a minimum of 50 hours to complete.)* What is your deadline for completion? (We only accept volunteers who have at least 6 months to complete their hours.)* MM slash DD slash YYYY What is the name and phone number of your probation officer?* Tell us about yourself and why you want to complete your community service at the Connecticut Humane Society.*What types of animals have you owned? (List species/breed)Do you have any professional or volunteer experience working with animals? Please explain.What skills do you have that might be useful to CHS?Have you ever been employed by the Connecticut Humane Society or Fox Memorial Clinic? Yes No Have you ever applied to volunteer at the Connecticut Humane Society or Fox Memorial Clinic? Yes No I verify that all information provided is true and accurate.* Yes No CAPTCHAThank you for submitting your application to volunteer for the Connecticut Humane Society. Due to the high volume of applications received, please allow up to two weeks to hear back on the status of your application. CHS is not able to process applications that do not meet the basic requirements.
