First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Cell Phone

Address*

Birthdate*

How Did You Hear About Us? Check/List all that apply 1. Petco 2. PetSmart 3. PetValu 4. Volunteer Match website 5. RTAC.org website 6. Idealist.org 7. AARP website 8. Friend/Colleague 9. Paws on Tour event 10. Facebook 11. Other*

What would you like to volunteer to do? (Top choice, Only select one)*

If you could not do your first choice, what would your second choice be?*

Are you comfortable with working with the public such as answering questions, or talking about ACDC Rescue?*

Describe yourself in 5 words or less *

Do you have any specific hobbies or skills that you think would be helpful to note for volunteer placement?*

What do you hope to gain from your volunteer experience? *

What is your current day available to volunteer on a weekly basis?

What time of day are you available to volunteer?

Can you make a 6 month or longer volunteer commitment?:*

Are you looking to volunteer as part of a community service requirement or class requirement?*

Do you require an aid or special assistance?

Have you ever been charged with a misdemeanor or felony, including a DUI?*
Choose one: Yes No

If yes, please indicate the nature of the offense, the date when charged with the offense, and the outcome (e.g. pending trial, community service, or jail time).*