Application - The Humane Society of Bay County

Step 1 of 4 – PERSONAL INFORMATION

NAME*

First Last

PHONE*

EMAIL*

ADDRESS*

Street Address City State ZIP Code

AGE*

18 OR OLDER

We do not accept anyone under 16 years of age

OFFENSE*

PROBATION OFFICER NAME*

PROBATION OFFICER PHONE NUMBER*
NUMBER OF HOURS NEEDED*
HOURS COMPLETED BY DATE*
MM slash DD slash YYYY

I understand that I am limited ONLY to the dates and times available for shifts, and that the Humane Society of Bay County does not accommodate any alternate scheduling.*

I Understand and Agree
I understand that I must register for opportunities ahead of time, and that the Humane Society of Bay County does not accept walk-in volunteers.*

I Understand and Agree
I understand that I must arrive on time and attend the FULL shift in order to receive credit for each date I attend.*

I Understand and Agree
I understand that I must abide by the Humane Society of Bay County health and safety policies.*

I Understand and Agree
I understand that the Humane Society of Bay County reserves the right to terminate my court-ordered service at any time, and for any reason.*

I Understand and Agree
I understand that I am required to purchase a volunteer t-shirt ($5.00) and wear the shirt while on the premises.*

I Understand and Agree
I understand that two (2) cancellations or no-shows of scheduled shifts will result in being ineligible for further service.*

I Understand and Agree
I understand that I am responsible for keeping track and turning in completed hours.*

I Understand and Agree
By submitting this form, you understand the requirements and guidelines of the community service program.*
I Understand and Agree
By typing my name below and submitting this form, indicates that I have read, understand, and agree.*
Full Name
Today's Date*
MM slash DD slash YYYY

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Comments
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Court-Ordered Community Service