Volunteer Application Form

Volunteer Application Form

Thank you for your interest in Volunteering with us.  Please fill out the form below and select the ‘submit’ button when you are ready to email it to our Volunteer Coordinator.  They will be in touch shortly after the form has been received to schedule your Volunteer Orientation Class.

As a Volunteer, Animal Samaritans will provide you with a t-shirt, name tag, and lanyard.  You must always wear identification (name tag) while volunteering for Animal Samaritans.  **We ask that you become a 1 paw member ($25.00) of the organization, which is tax deductible to cover the costs of these items.  If you wish to purchase additional shirts, you may at $10.00 each.

Volunteer Orientations are held on Saturdays once a quarter.  Please contact our Volunteer Specialist at volunteer@animalsamaritans.org or call 760.601.3758 to find out more information and reserve your spot today.

Application Form

* Required

Title

First Name*

Last Name*

Street Address*

City/State/Zipcode*

Home Phone#*

Cell Phone#*

Email Address*

Birthday*

IN CASE OF EMERGENCY

Contact First Name*

Contact Last Name*

Contact Phone Number*

Relationship to Volunteer*

IF APPLICANT IS UNDER 18
(Critter Camp Counselors can be 15 and over)

Parent/Guardian Name

Parent/Guardian Phone

Parent/Guardian Email Address

Areas of Interest*
Animal Assisted Therapy**Clinic GreetersDoggie Day Out!Dog SocializersDog WalkersCat Cuddlers/SocializersEventsFoster ParentingGeneral Shelter HelpCritter Camp Aids ~ 15 and overHighway Heroes (Transport)Off Site AdoptionsCommunity EventsShelter Front Desk

**If interested in Animal Assisted Therapy please tell us the name, breed, and age of your pet

TELL US ABOUT YOURSELF

SPECIAL SKILLS
Microsoft Word and/or ExcelClericalHandymanKennel CleaningDog TrainingGroomingArts & CraftsTeaching AdultsTeaching ChildrenPublisher or Constant ContactOther

Please tell us about your other skills

PREFERRED LOCATION
Thousand PalmsIndio

VOLUNTEER EXPERIENCE

Please list area and organization

Please list any allergies, medical problems or other issues which we should be aware of to insure a safe volunteer environment.

AVAILABILITY

Are You a Year long resident?
YesNo

If no, what is your summer address and the months you are in the Desert?

Days Available:*
Monday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PMSunday AMSunday PM