Community Service* Volunteer

Please complete this application form if you are interested in fulfilling your court-ordered community service hours* at the Humane Society of Macomb. Once you complete the form, click the submit button at the bottom.

*The Humane Society of Macomb does not accept all offenses.

This form is for COURT-ORDERED Community Service hours only. If you need community service hours for school, work, church, etc. please fill out the Volunteer Application.

Applicant Information

All community service workers must be at least 16 years or older. All minor volunteers must have a signed waiver on file; parents must come in to the shelter to sign.

First name*:

Last name*:

Title*:

Street 1*:

Street 2:

Street 3:

City*:

State*:

Zip*:

Home phone*:

OK to call me here

Cell phone*:

OK to call me here

Email address*:

Date of birth*:

Age*:

Offense Information

Charge indicated on court-ordered offense paperwork

I would like to serve up to*:

Hours*:

Please list the offense and the county in which the offense occurred*:

Name & Contact Info of Probation Officer

Emergency Contact & Information

1

First name*:

Last name*:

Street 1:

Street 2:

City:

State*:

Zip:

Home phone*:

Cell phone*:

Relationship:

2

First name*:

Last name*:

Street 1:

Street 2:

City:

State*:

Zip:

Home phone*:

Cell phone*:

Relationship:

Do you have any medical conditions that could affect your community service work? Allergies, Asthma, or disabilities?

Terms and Conditions

We/I give my permission for my child/or myself to work/volunteer at the Humane Society of Macomb Animal Shelter. We/ I understand that community service tasks will include general labour such as cleaning, organization, yard work, etc. and no animal interaction other than possible bathing and kennel cleaning.

As a community service worker at the Humane Society of Macomb, I recognize and acknowledge that during the course of my duties I may have access to certain information not generally known to the public. Community service workers may not divulge confidential information about the Humane Society of Macomb’s employees, volunteers, customers, or adopters and confidential animal information without the written consent of the Humane Society of Macomb. Further, neither the Humane Society of Macomb nor the community service worker shall make any negative or disparaging comments or remarks about the other party.

We/I agree that the Humane Society of Macomb may photograph my child/ myself during my participation in the shelter. And we/ I hereby release any such photographs to the Humane Society of Macomb for use in programs, publications and other purposes.

We/ I agree to bring in my vaccination record (showing tetanus valid within last ten years) to be able to volunteer or know we/ I will be sent home.

We/ I agree to go through a one-hour volunteer orientation before working with any of the animals in the shelter. Orientation times are scheduled Saturdays 10:30a-11:30a. Community service workers will receive e-mailed notifications of upcoming schedule changes.

I Agree