Butler County Humane Society : Community Service Application

Community Service Application

Please complete the fields below, then click the submit button.

Name:

Email:

Address:

Phone Numbers

Home:

Alternate

Please select your age group:

(applicants must be at least 16 yrs. of age in order to apply)

How did you hear about the Butler County Humane Society?

What kind of animals do you presently own?

How many hours total community service must you complete?
(ex. 100 hours; 4 hours a week; 8 hours a month etc)

Reason for performing community service?

How long?

(what is the length of time committing to doing community service at the shelter…ex. 1 month; 6 months; etc)

Days you are available:

(Choose the days you will commit to performing community service on a continuous basis until your required community service hours are completed)

Sun:

Mon:

Tue:

Wed:

Thu:

Fri:

Sat:

Hours you are available?

Are you currently employed?

Do you have a specific skillset?

Do you have any physical or medical limitations?

If yes, please explain:

In case of an emergency, whom should we notify?

Name:

Phone:

Start Date:

End Date:

Shift:

Dept:

Organization:

Counselor:

Phone:

To comply with the order to complete hours of community service, the Butler County Humane Society is given the authority to oversee your work and direct your activities during the time you are scheduled at the shelter.

You are expected to:

Maintain a good attitude.
Respect staff, volunteers, and the general public.
Maintain a record of your time by signing in and out of the sign in book located at the front desk.
Perform your assigned duties.
Handle all animals with care and kindness.
Report for your shift and to your supervisor on time. If you are unable to make your scheduled shift, and you do not contact the Community Service Coordinator, after the third occurrence you will be dismissed, you must contact the BCHS Community Service Coordinator or your supervisor in advance.
You are not permitted to walk or take animals from the building unless you have completed the volunteer orientation and training process (which is different from regular community service orientations) and have been accepted into the volunteer program.
You must notify the BCHS Community Service Coordinator when you have completed your community service.
You must provide a current form of photo identification prior to starting community service hours.
BCHS does not guarantee the availability of service hours to meet court ordered deadlines.

Failure to disclose any information and/or misconduct will result in immediate dismissal.

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