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Volunteer Application Form

  1. I have read and understand the General Liability Release on pages 15 & 16 of the RAS Volunteer Standard Operating Procedures*
  2. Contact Information
  3. Please Print:
  4. Skills & Interest
  5. Have you had any formal training in animal care or animal welfare?*
  6. Volunteer Goal*
    Please check all that apply:
  7. Preferences in Volunteering*
    To help us match you with assignments you enjoy, please check the types of volunteer activities that interest you. Check all that apply:
  8. Are there specific tasks you are unable to perform due to physical limitations or personal preference?*
  9. Do you understand that some animals are euthanized at the facility?*
  10. Will you have any problems volunteering knowing this?*
  11. Availability
  12. Background Information
  13. Have you ever been convicted of a criminal offense?*
  14. Have you ever worked or volunteered for an animal welfare organization such as S.P.C.A., P.E.T.A., Humane Society, ect.? *
  15. List Species/Breed, Rabies tag #, and County License #
  16. Our volunteer program requires the following screening for all persons interested in volunteer positions. (Does not apply for court ordered services.) Regional Animal Shelter requires all court ordered/community diversion services to provide documentation from the court referral source.
  17. Criminal Records Check:
  18. If you do not have a valid driver's license please add N/A.
  19. If you do not have a valid driver's license please add N/A.
  20. Do you consent to the performance of the above screenings prior to placement?*
    Please note, your refusal to do so may exclude you from consideration for some or all types of volunteer activities with our organization.
  21. The following certification is required by the Code of Virginia 3.2-6548.*
    I certify that I have never been convicted of any crime or misdemeanor involving animal cruelty, neglect, or abandonment.
  22. Leave This Blank:

  23. This field is not part of the form submission.