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 Apt./Unit City State Zip Code Email* Cell Phone*Home 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 Please do not proceed with this application until you have watched the virtual open house video: https://cthumane.org/volunteer/openhouse/ What was the code word at the end of the presentation?*Are you 18 or older?* Yes No Do you have active health insurance? (Health insurance is required for all volunteer positions.)* Yes No Are you able to commit to at least 6 consecutive months of service?* Yes No CHS practices limited euthanasia for medical and behavioral reasons. Will you be respectful of these decisions?* Yes No Which of the posted volunteer openings are you applying for? Make sure to list the job title and shift (day/time). List all posted positions/shifts that interest you as some openings may be filled by the time your application is reviewed.*Visit cthumane.org/volunteer and click the link for the location closest to you to see posted openings. 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 job coach?*I can work independentlyI will require support from a trained parent or guardianHave you been convicted of a crime in the past 7 years?* Yes No Please list the nature of the offence.Tell us about yourself and why you want to volunteer for 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 or volunteered for the Connecticut Humane Society or Fox Memorial Clinic? No Yes, Employed Yes, Volunteered I verify that I meet all the Essential Capabilities as detailed below.* Yes No PHYSICAL CAPABILITIES ï‚· Ability to see to distinguish animal body language and read instructions. ï‚· Ability to hear warnings, such as growling or hissing. ï‚· Ability to stand and/or walk for significant periods of time. ï‚· Ability to travel unaided on varied surfaces. ï‚· Ability to bend and squat in order to leash/harness, and/or pick up an animal. ï‚· Quick reflexes and ability to safely open a cage door while handling an animal. ï‚· High level of manual dexterity to leash/harness animals. ï‚· Ability to cope with a loud environment due to animal noises. ï‚· Ability to work in the presence of peanut butter, cat, dog and small animal dander as well as cleaning chemicals. COGNITIVE ABILITIES ï‚· Ability to understand, remember and follow both verbal and written instructions and procedures. ï‚· Basic reading, writing and communication skills. ï‚· Ability to recognize potentially hazardous situations. ï‚· Ability, once trained, to work independently with minimal supervision. ï‚· If unable to work independently, must be able to work alongside a trained parent or guardian in an appropriate job, as determined by the volunteer department. ï‚· Ability to understand and safeguard against the risk of exposure to zoonotic diseases such as ringworm or animal bites or scratches.I agree to the following: *I understand that volunteers do not receive any compensation for their service and that there are risks involved in volunteering with animals. I will not hold the Connecticut Humane Society responsible for injury or illness to myself or my animals, or loss of or damage to my personal property. *I agree to immediately report any bites or incidents to the manager-on-duty and understand that this is necessary to keep others safe and so CHS can comply with state laws regarding rabies observation quarantines. *I authorize the Connecticut Humane Society to use any photographs or audiovisual images of me for promotional use or for any other use for the benefit of the organization.* 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.
