Lange Foundation
2106 S. Sepulveda Blvd.
Los Angeles, CA 90025

Volunteer Application and Agreement

Thank you for your interest in Lange Foundation. Our organization is a non-profit California corporation devoted to rescuing cats and dogs from the Los Angeles Shelters. Volunteers with a variety of skills are needed.

Please take the time to review our Volunteer and Pet Safety Manual and this short Application and Agreement, and, if not currently on our premises, return it to the address above. After we review your information, you will be contacted regarding your availability to volunteer, and the activities in which you have expressed interest.

Please print all information!

Today's date ______________________________________________________

Your name _______________________________________________________

Your address ______________________________________________________
 

Daytime phone __________________________ Evening phone ________________________

Occupation _________________________________________________________________

Employer's name _____________________________________________________________

Employer's address ___________________________________________________________

Employer's phone _____________________________________________________________


List three references, one of which should be your veterinarian, (if you have one).

Name Phone Relationship

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

 

List your animal organization affiliations, with positions held.

_____________________________________________________________________________________
_____________________________________________________________________________________

Do you presently own a dog or cat?      Yes     No
If yes, please describe.
 

Cat Dog Breed/Mix Sex Age Where Obtained

1. _______________________________________________________________________________

2. _______________________________________________________________________________

3. _______________________________________________________________________________


Have you owned dogs or cats in the past?     Yes     No
If yes, please describe what happened to them. For example, "gave away because..." or "was lost because..." or "died from...".
 

Cat Dog Breed/Mix Sex Age What Happened?

1. _______________________________________________________________________________

2. _______________________________________________________________________________

3. _______________________________________________________________________________


Do you have any experience or training in the following pet related areas?

Training                        Yes      No Grooming                          Yes      No
Vet Assistant                Yes      No Kennel Assistant                Yes      No
Pet Store Sales             Yes      No Animal Rescue                   Yes      No

Please explain any areas you checked "yes".

_________________________________________________________________________________

What type of volunteer work would you like to do?

_________________________________________________________________________________

Which hours and days of the week can you volunteer?

_________________________________________________________________________________

 

Volunteer Agreement

In consideration of this opportunity to volunteer, I agree to the following terms and conditions, intending to be legally bound by them:

1. I will abide by the mission, rules, regulations, policies and programs of Lange Foundation while I am a volunteer.

2. I assume the risks of being bitten, scratched, injured, or frightened by cats, kittens, dogs and puppies in connection with the volunteer work for the Lange Foundation. Lange Foundation is not liable to me for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever which I might suffer or sustain in connection with the performances of my volunteer activities for Lange Foundation, unless they are the result of Lange Foundation's gross negligence or intentional misconduct. I will indemnify, defend and hold Lange Foundation harmless from costs or expense whatsoever, sustained by any companion animal or any person in connection with my intentional misconduct or grossly negligent performance of volunteer activities for Lange Foundation, or my breach of Lange Foundation's rules, regulations, policies, and programs.

3. I understand and agree that Lange Foundation may refuse volunteer applications for any reason.

4 If I will be sheltering or providing foster care or boarding any of Lange Foundation's animals in my home or business, I consent to Lange Foundation visiting my home or business from time to time to observe the animals and their living quarters.

5. I have accurately and truthfully completed this volunteer Application and Agreement, and read the Volunteer Handbook.

Dated: _____________________________

Applicant

___________________________________
Sign name

 

Lange Foundation

By ________________________________

Position ____________________________