Volunteer Form

MOMSVA (Making of Miracle Stories Animal Rescue of VA) Volunteer form

Thank you for your interest in volunteering.Please complete the following questions.

Please select any volunteer OPPORTUNITIES in which you have interest: *

Volunteer Information

* Indicates required field

Name *

First

Last

Address (street, city, state, zipcode) *

HOME Phone Number (with area code) *

WORK Phone Number (with area code) *

CELL Phone Number (with area code) *

Emergency Contact NAME *

Emergency Contact Phone Number (with area code) *

What is your best contact number? *

Home phone number Work phone number Cell phone number

What is the best time for us to call you? *

EMAIL address *

Are you under 18 years of age? *

Yes No

If YES, please provide your age. If you are under age 18, your parent/guardian must also complete a separate online Volunteer Inquiry. *

PARENT/GUARDIAN of a MINOR: Please list below the name of the minor that your inquiry is accompanying. *

Please REVIEW & SIGN

Please read and initial the following information required by VA law for all volunteers of canine rescue organizations.
Please note: You must sign this before volunteering in any capacity.; your initials represent your signature.

1. RELEASE: I, the undersigned volunteer (or parent/guardian) (if volunteer under 18) understand and agree that a possibility of injury may occur while working with animals. I, the undersigned volunteer (or parent/guardian), desiring to donate my time and talents to MOMSVA (Making of Miracle Stories Animal Rescue of VA) due hereby release MOMSVA (Making of Miracle Stories Animal Rescue of VA) from any loss or injury that may result from my volunteer activities. 2. POLICIES & PROCEDURES: I, the undersigned volunteer or parent or guardian (if volunteer under 18) agree to review, understand, and support all MOMSVA (Making of Miracle Stories Animal Rescue of VA) policies and procedures. 3. STATEMENT REQUIRED BY VIRGINIA LAW [Code § 3.1-796.96(2)] : A Virginia law went into effect on July 1, 2003 requiring all “home-based rescues,” which would include MOMSVA (Making of Miracle Stories Animal Rescue of VA) within its definition, to obtain signed statements from anyone adopting from, volunteering with, or connected to us in any capacity that the individual “has never been convicted of animal neglect, abandonment, or cruelty.” I, the applicant on this form and undersigned volunteer or parent or guardian (if volunteer under 18), am connected with a home-based rescue as defined under Virginia law, specifically MOMSVA (Making of Miracle Stories Animal Rescue of VA), as a volunteer, fostering individual, and/or adopter. With my signature below, I attest that I have never been convicted of animal neglect, abandonment, or cruelty. SIGNATURE/NAME OF APPLICANT (enter your initials) *

Signature/Name of parent or guardian (if volunteer is under 18) *

DATE *

Upon clicking SUBMIT, your application will be sent to [email protected] for review.

Submit

Who will find a new FurEver home next? Check out our Find a Best Friend page to see who will join these wonderful dogs who found new homes!

Please consider helping through donation. Any and all amounts are appreciated. Every penny is used to rescue the dogs.

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Ways to Help the Dogs

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BECOME A VOLUNTEER