Contact InformationName* First Last TitleMr.Mrs.Ms.NoneStreet 1*Street 2Street 3City*State*Zip*Mobile Phone OK to call me here Home Phone* OK to call me here Work Phone OK to call me here DemographicsYou may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.Date of BirthMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920EducationHighschool GraduateAssociate DegreeBachelor DegreePost - GraduateSkills & ExperienceIn which of these areas do you feel you have moderate to excellent skill? Check all that apply.Skills Administrative Animal Taxi Dog Walking Adoption Counselor Bathing/Grooming Fostering Animal Care Community Outreach Special Events Fundraising Photography Other(s). Please specify.AvailabilityPlease indicate the days and times you are usually available to volunteer.Morning Wednesday Thursday Friday Saturday Evening (5-9 PM) Monday Tuesday Wednesday Thursday Friday Saturday Please list any other days/times that you would be available to help our canine companions.Assignment PreferenceThe following volunteer assignments may currently be available. You may click the assignment names to learn more about that assignment. Use this list to rank your top three assignment choices.Assignment Preference Adoption Coordinator Bathing/Grooming Dog Walking Enrichment Office Assistant Photography Fundraising Other(s). Please specify.Emergency ContactIn the event of an emergency whom should we notify?Name* First Last Mobile Phone*Home PhoneWork PhoneRelationship*Spouse or PartnerParentChildOther Family MemberFriendSupervisorOtherEmployerPlease list your current or most recent employer, if applicable.Are you employed?* Yes No Employer Name** First Last Street 1*Street 2Street 3City*State*Zip*Work Phone*Driver's LicensePlease provide a copy of your driver's license. This is required by the NC Department of Agriculture, Animal Welfare Division, who administer our license as a dog rescue and boarding facility. This can be a photograph or PDF file.File UploadMax. file size: 128 MB.EmailWe like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.Email* What kind of email would you like to receive? Electronic Newsletters Recruitment Appeals How did you hear about us?Please indicate how you heard about Godbey Creek Canine Rescue: Through Facebook, Twitter, Website, Newspaper Article, E-Newsletter, TV, Radio, Magazine, Newspaper Ad, Flyer, Event, Share CLT, word of mouth, other (please indicate how below)Through Facebook, Twitter, Website, Newspaper Article, E-Newsletter, TV, Radio, Magazine, Newspaper Ad, Flyer, Event, Share CLT, word of mouth, other (please indicate how below)Why do you want to volunteer with Godbey Creek?Please write a brief summary as to why you have chosen to volunteer with Godbey Creek Canine Rescue.Please write a brief summary as to why you have chosen to volunteer with Godbey Creek Canine Rescue.Other InformationGodbey Creek Canine Rescue requires all applicants to state any past criminal record and reserves the right to conduct a background check on any volunteers. (NOTE: No applicant will be denied the opportunity to volunteers solely on the grounds of a conviction for a criminal offense. The nature of the offense, the surrounding circumstances, and the relevance of the offense to the position(s) applied for may, however, be considered) Have you ever been convicted of or pleaded guilty to a misdemeanor or felony, including sex-related or child abuse related offenses. Please answer yes or no.Have you ever been convicted of or pleaded guilty to a misdemeanor or felony, including sex-related or child abuse related offenses. Please answer yes or no. If yes, please describe the nature of the crime(s), when and where convicted and the disposition of the case:* Yes No If yes, please describe the nature of the crime(s), when and where convicted and the disposition of the case:I AgreeI understand and agree that submitting this application form does not automatically register me as a Godbey Creek Canine Rescue volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. By submitting this form, I attest that the information I have provided on the form is true and accurate. As an agency that houses homeless animals, Godbey Creek, often does not have a complete medical history for animals that volunteers may encounter. While some training is provided, a certain amount of risk is always involved, especially with unpredictable animals. We strongly recommend that all volunteers have current tetanus vaccinations. In consideration of this opportunity to volunteer at Godbey Creek Canine Rescue, I agree to the following terms and conditions, intending to be legally bound by them: 1. I will abide with the mission, rules, regulations, policies, and programs of GCCR. 2. If I decide to remove myself as a volunteer at GCCR, or upon request by GCCR, I will promptly return all GCCR supplies, equipment, records, animals, moneys, and other items in good, clean condition. 3. I assume the risk of being bitten, scratched, or injured in connection with my GCCR volunteer work. GCCR is not liable for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever, which I might suffer or sustain in connection with my GCCR volunteer activities, unless they are the result of the gross negligence or intentional misconduct of GCCR. I will indemnify, defend and hold the GCCR harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever, sustained by any animal or person in connection with my intentional misconduct or grossly negligent performance of my volunteer activities, or my breach of GCCR rules, regulations, policies, and programs. 4. I understand that GCCR may refuse or cancel volunteer applications for any reason. 5. I have accurately and truthfully completed this Volunteer Application and Agreement. 6. Any modification to this Agreement must be in writing and signed by both parties. This Agreement is binding upon the GCCR, me and the GCCR and my respective heirs, successors, assigns, executors, and personal representatives.I understand and agree that submitting this application form does not automatically register me as a Godbey Creek Canine Rescue volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. By submitting this form, I attest that the information I have provided on the form is true and accurate. As an agency that houses homeless animals, Godbey Creek, often does not have a complete medical history for animals that volunteers may encounter. While some training is provided, a certain amount of risk is always involved, especially with unpredictable animals. We strongly recommend that all volunteers have current tetanus vaccinations. In consideration of this opportunity to volunteer at Godbey Creek Canine Rescue, I agree to the following terms and conditions, intending to be legally bound by them: 1. I will abide with the mission, rules, regulations, policies, and programs of GCCR. 2. If I decide to remove myself as a volunteer at GCCR, or upon request by GCCR, I will promptly return all GCCR supplies, equipment, records, animals, moneys, and other items in good, clean condition. 3. I assume the risk of being bitten, scratched, or injured in connection with my GCCR volunteer work. GCCR is not liable for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever, which I might suffer or sustain in connection with my GCCR volunteer activities, unless they are the result of the gross negligence or intentional misconduct of GCCR. I will indemnify, defend and hold the GCCR harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever, sustained by any animal or person in connection with my intentional misconduct or grossly negligent performance of my volunteer activities, or my breach of GCCR rules, regulations, policies, and programs. 4. I understand that GCCR may refuse or cancel volunteer applications for any reason. 5. I have accurately and truthfully completed this Volunteer Application and Agreement. 6. Any modification to this Agreement must be in writing and signed by both parties. This Agreement is binding upon the GCCR, me and the GCCR and my respective heirs, successors, assigns, executors, and personal representatives.* I Agree Δ