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Volunteer Application

2. 
4. **Please note: To volunteer onsite, you must be 16 years or older. We do have other volunteer opportunities for those younger than 16**
6. Legal First Name*
7. Legal Last Name*
9. Preferred Name: *
10. Date of Birth:*
    Date of Birth:
12. Home Address:*
14. City*
15. State*
16. Zip*
18. Primary Phone Number:*
19. Secondary Phone Number:
21. Email*
25. Parent/Legal Guardian Name (if under 18 years old):
27. Parent/Legal Guardian Home Address:
29. City
30. State
31. Zip
33. Parent/Guardian Phone Number:
34. Parent/Guardian Secondary Phone Number:
36. Emergency Contact Legal Name (First and Last):
38. Relationship to Applicant:
40. Emergency Contact Phone Number:
41. Emergency Contact Secondary Phone Number:
45. Is your interest in volunteer for NACC in order to gain pre-court date community service hours or Court ordered community service hours?

    1. Yes
    2. No
49. Previous Volunteer Experience or experience working with animals:*
53. From the following, please check all activities you are willing to help us with:*

    1. Walking Dogs
    2. Socializing Cats
    3. Cleaning Cat Cages
    4. Helping at Adoption Events
    5. Customer Service
    6. Putting Away Donations

    1. Animal Photography
    2. Helping with Special Events
    3. Washing Dishes and Doing Laundry
    4. Assisting with Animal Transports
    5. Cleaning Dog Kennels
    6. Landscaping Work
57. Terms and Conditions:
59. 1. I acknowledge that my volunteer services are strictly voluntary, without pay or compensation of any kind, and without liability of any nature on behalf of the Norfolk Animal Care & Adoption Center (NACC) *
60. Date*
    Date
62. 2. I acknowledge that NACC does not guarantee the temperament, behavior, or health of any shelter animal. *
63. Date*
    Date
65. 3. I attest that I have never been charged with or convicted of animal cruelty, neglect, or abandonment. *
66. Date*
    Date
68. 4. I acknowledge that falsifying any information on this form will immediately disqualify me from volunteering at NACC. *
69. Date*
    Date
71. 5. I acknowledge that court mandated & pre-court community service will be accepted on case-by-case basis and the Volunteer Coordinator will reach out to the probation officer prior to decision making. *
72. Date*
    Date
74. 6. I acknowledge that my application does not guarantee placement into the volunteer program. *
75. Date*
    Date
77. 7. I acknowledge that if a minor is 16-17 years old then a parent/legal guardian must volunteer alongside. *
78. Date*
    Date
80. By e-signing below, I agree to the Terms and Conditions outlined above and the information I provided is factual:
82. Volunteer Signature (Legal First and Last Name)*
83. Date*
    Date
85. Parent/Legal Guardian Signature (Legal First and Last Name)
86. Date
    Date
88. Once you have submitted this application you will receive an e-mail from our Volunteer and Outreach Coordinator with a link to sign up for our Volunteer Orientation held online via Zoom. If unable to join online, please let us know so we can make alternative arrangements. The Volunteer and Outreach coordinator can be reached at: volunteerNACC@Norfolk.gov Thank you for your interest and you will be hearing from us soon!
Leave This Blank:


90. 1. Receive an email copy of this form.
91. Email address

    This field is not part of the form submission.

92. Submit

* indicates a required field