First Name

Last Name

Phone Number

Your Email

Address 1

Address 2

City

State

Zip Code

Employer

Occupation

If you are not employed, please explain why:

Why do you want to volunteer for Zoofari/Wild Wonders (other than your love for animals)?

Have you participated in a volunteer program before?
 Yes No

If yes, please describe the type of program, when, and what duties you performed as a volunteer:

Are you currently participating in the above volunteer program?
 Yes No

If no, please explain why:

Do you have any experience working with exotic animals?
 Yes No

If yes, please describe the species and your duties:

Do you have any work experience that may help you in your duties here?
 Yes No

If yes, please describe:

What is the highest level of education you have completed?
 High School Some College College Graduate

Degree:

Are you currently enrolled in school?
 Yes No

If yes, what's your major?

How did you find out about us?
 Friend Website Job Listing Service

Other:

How much time will you commit to volunteering?

What days will you be available to volunteer: (please check all that apply)
 Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Do you have any medical (physical or mental) conditions, disabilities or other limitations (allergies, pregnant, back or neck injuries, etc.) that may prevent you from safely and effectively fulfilling the requirements of the position for which you apply?
 Yes No

If yes, please describe:

Have you ever had a history of or currently have any of the following illness/medical conditions? (Check all that apply)
 Herpes Simplex Hepatitis Back problems Tuberculosis Arthritis

Do you live with pets (domestic or exotic) or are in contact with other animals?
 Yes No

If yes, please describe:

Have you ever been charged or convicted of any felony within the past 10 years?
 Yes No

If yes, please describe the charges, including the date charged, and the final outcome (e.g., dismissed, guilty, fined, prison time):

Have you ever been charged or convicted of any crime involving dishonesty or breach of trust such as theft or falsification?
 Yes No

If yes, please describe the charges, including the date charged, and the final outcome (e.g., dismissed, guilty, fined, prison time):

Emergency Contact Information:

Name

Relationship

Phone

Any other details comments or questions: