Name (Must be at least 16 years of age and will require parental consent) *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

May we contact you during work/school hours?

Yes

No

Do you have a valid drivers license? (Required if you are transporting rescues) *

Yes

No

Areas of Interest- On Site Opportunities:

Working with the dogs

Working with the cats

Building maintenance

Grounds maintenance

Areas of Interest- Jobs Requiring Experienced HSCC Members or Specialized Skills:

Grant Writing

Fundraising or Events

Advertising/Marketing

Legal Advice (other than court representation)

I CERTIFY that all information provided is accurate, UNDERSTAND that all applications will be processed for accuracy and references checked, UNDERSTAND that applications that are incomplete may be voided and not contacted, UNDERSTAND that HSCC may request additional information abut the applicant, UNDERSTAND that HSCC has the right to deny any applicant for any reason.

Yes