General Volunteer Application & Agreement Step 1 of 5 - Requirements 20% Name* First Last Organization/Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneWork PhoneCell PhoneFaxEmail* Are you over 18 years old?* Yes No Volunteer QuestionsWhy are you interested in volunteering for WAGS? Previous volunteer work?WhereWhenType of work performed Volunteer TalentsPlease check all that interest you:* Handling cats Handling dogs Dog walking Pet Adoption Shows Laundry/Litterboxes Kennel Care/Cleaning Construction work Transporting pets to C.A.R.E. programs Preferred days and times* Monday Tuesday Wednesday Thursday Friday Saturday Sunday Hours?* 8-12pm 12-4pm 4-7pm Availability?*Hours per month? Do you have any allergies or conditions that might affect your volunteer work?* Yes No If yes please describe:Are you a convicted felon?* Yes No Emergency Contact Information:Name* First Last Phone*Alt Phone By signing this agreement, I understand and agree to the following:I declare that the information provided and statements made in this application are true and complete to the best of my knowledge and believe. I also declare that I understand that the purpose of the training I receive as a SHIP volunteer is to provide services free of charge top Medicare beneficiaries and is not to be used for my personal monetary gain.Signature (digital)*Please type your full name to acknowledge Date*Agreement* I certify that the information I have given is true, and I authorize WAGS to verify any/all information provided. I further agree to a background check for any criminal history.