Janet's Rescues and Placements

P.O. 6057
Dale City, VA 22195
Phone: 703-580-5082
Email: jhollins25@comcast.net

Volunteer Questionnaire

Full Name: Birth Date:
Home Address: City, State, Zip:
Home Telephone: E-mail Address:

Work Telephone: Mobile Telephone:

Best Time to Contact You:

Why are you interested in becoming a rescue volunteer with us?

If you have previous experience working with animals? Please describe.

If you have previous experience volunteer experience with other organizations, please describe:

When? Organization?

Duties?

If you have any disabilities or limitations that could affect your ability to perform certain tasks with us, please describe:

Last Year Education Completed: (Select One)
High School 1 2 3 4 College 1 2 3 4
Grad School 1 2 3 4
Other special training:

Are you presently employed or attending school? Yes No

Employer / School Name and Address:

Normal Hours:

Please list any special skills, training, interests or hobbies you believe are relevant.

Please mark the boxes of all areas of interest for volunteer positions:
(Please note, training/mentors provided.)
Foster Home for animals during the week and delivery to adoption site Saturdays/Sundays
Adoption site set up/break down/cleaning/dog walking, etc.
Adoption Counselor (train to interview, qualify adoptors and document adoptions on weekends)
Adoption Follow Up Volunteer – call recent adopters to ensure smooth transition
Transport/Rescue Volunteer – requires reliable transportation to transport animals to and pick up from vets, help rescue animals, deliver food to fosters, etc.
Newsletter Volunteer – writers, preparation, production, coordination
Fund Raising/Public Relations- experience or interest in sales, marketing/PR/various event production projects, on-site event assistance, committee chairs for projects
Bake/Craft Sales – provide goodies for our bake sales every other month
Administrative Volunteer – data entry, mailing campaigns, web site assistance, special projects

Any areas for which you have specific interests not previously listed?

What times would you generally have available on specific days for volunteer work?

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Other
(i.e. evening or summer availability)

What type of transportation do you have available?

Additional information you’d like to offer:

In case of emergency, notify:

Home Phone: Work Phone: