Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is your age? *

Under 18

18-29

30-54

55+

Are you a veteran or service member? *

Yes

No

Are you a participant in Paws for Purple Hearts Canine Assisted Warrior Therapy or a client of PPH? *

Yes

No

Weekday Volunteer Availability

Select which time of day you are available to volunteer during weekdays.

Mornings

Afternoons

Evenings

Weekend Volunteer Availability

Select which time of day you are available to volunteer during weekdays.

Mornings

Afternoons

Evenings

Will you need a record of your volunteer hours? *

Yes

No

Basic Dog Handling

Puppy Petter

Play Facilitation

Dog Walking

Dog Grooming/Bathing

Puppy Sitting - keeping a dog in your home for a short period of time, such as a weekend or weeknight, not on a regular basis.

IT

Computer Programming/Coding

Data Entry

Graphic Design

Facility Support

Cleaning

Maintenance

Gardening/Landscaping

Moving/Construction

Marketing

Fundraising or Outreach

Event Planning/ Support

Public Relations

Are there any other skills you have that you would like to provide to us as a volunteer:

Why would you like to volunteer for Paws for Purple Hearts? *

Please list your previous volunteer work experience: *

Reference Information

Please provide contact information for someone we can contact as a reference. *

First Name

Last Name

Reference Phone *

(###)

###

####

Reference Email *

Reference Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Information

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Emergency Contact Email

Emergency Contact Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Volunteer Applicant Agreement and Liability Waiver

I have read and agree to the Volunteer Applicant Agreement and Liability Waiver below *

Yes

No

Volunteer Applicant Agreement and Liability Waiver

In anticipation that you will be accepted into Paws for Purple Hearts' volunteer program, please read and sign the agreement below.

I declare that the above information is accurate. I authorize Paws for Purple Hearts to seek emergency medical treatment in case of an accident, injury, or illness. I understand that if I am injured while acting as an unpaid member of the volunteer staff that I am not covered by applicable state Worker’s Compensation Law. I understand that working with dogs involves risks, including possible injury, illness, death, damage to or destruction of property, and I choose to volunteer with Paws for Purple Hearts of my own free will with full knowledge and acceptance of those risks. I indemnify and hold harmless Paws For Purple Hearts from and against any and all claims, losses, liabilities and damage to persons or property, expenses, costs and/or attorneys' fees arising out of the acts or omissions of Paws For Purple Hearts, its directors, officers, agents or employees, and I agree that anything whatsoever that happens relating to the dogs, their training, or my volunteer work with dogs will not result in any claims against Paws For Purple Hearts, its directors, officers, agents or employees by me or anyone acting on my behalf for personal injuries or property damages. If I volunteer through the Department of Veterans Affairs ("VA"), Department of Defense ("DOD"), a state Veterans services department, or similar host organization, I understand and agree that any claims I may have that are related to the program will be referred to the host organization and that the host organization may, at its own discretion, pursue those claims further.