Volunteer Registration Form

Important! Please enter your information carefully - extra spaces, especially leading spaces, or not filling in all fields, will generate an error message.

In order to appropriately run a background check, please provide your complete legal name below:

First Name

Middle Name

No Middle Name

Last Name

Suffix

Preferred First Name

Birthday

Username

Password

Confirm Password

Address

Street Address

City

State

Zip Code

Resident County

Contact

Email Address

Phone # (no dashes)

Emergency Contact Name

Emergency Contact Phone (no dashes)

Emergency Contact Email

Other

Who referred you to Pets On Wheels?

Please provide any information relative to your special skills/talents/resources that may assist Pets on Wheels in the future. We also want to help promote local businesses so please specify if you own a business.

I have read and agreed to the following terms*:

My pet is at least one year old at the time of application submission.
I have owned my pet for at least 6 months at the time of application submission.
My pet is friendly with other pets.
I will only visit with one pet at a time (unless a special exception has been requested and approved).
I will not be accompanied on visits by anyone who is not also a currently active Pets on Wheels volunteer, including family members (unless a special exception has been requested and approved).
I have never been convicted of a criminal offense.
I am 18 years old or older, or I am 16 years or older and agree to volunteer with a guardian in visiting a facility or with a guardian's consent in participating in an event.
I agree to receive emails from Pets on Wheels.

*Failure to meet the terms above will result in your ineligibility to volunteer with Pets on Wheels.

Volunteer Registration Form

Address

Contact

Other

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