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					                  PAWS
           San Diego County, Inc.
               Pets Are Wonderful Support

 Providing essential services to assist low-income elderly,
   chronically ill, and disabled in keeping their beloved
                     companion animals.




               VOLUNTEER APPLICATION




110108
PAWS San Diego County, Inc.
Pets Are Wonderful Support
Page 2
                          PAWS San Diego County, Inc
                    CONFIDENTIAL VOLUNTEER APPLICATION

PERSONAL
First Name:                             Last Name:


Street Address:


City:                                   ____    State:            Zip:


Home Phone:                             Cell Phone:


Personal Email:


Emergency Contact: _____________________________ Phone: _________________


Occupation:                             _____


Employer:                         ___________ Supervisor:


Business Address:
City:                                                    State:          Zip:
Work Phone:                        Business Email:
May PAWS contact you at work regarding volunteer service matters?


Birth Day and month:                    Driver’s License #:
Driver’s License Issuing State:




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Have you ever been arrested?                         Yes         No
Have you ever been convicted of a crime?             Yes         No
If yes, please explain:




Do you have companion animals?  Yes  No If yes, what kinds, breeds, names?
_________________________________________________________________________


___________________________________________________________________________




EDUCATION
Highest Level of Education Completed:               Major/Degree:
Are you a student now?          Yes         No
Are you multilingual?           Yes         No


Languages:


ADDITIONAL
Do you have any physical limitations or disabilities?  Yes       No
If yes, please explain:




How do you describe your ethnicity?
 African American         Asian    Caucasian      Hispanic/Latino
 Native American
 Other (please specify):

P.A.W.S. does not discriminate on the basis of race, ethnicity, religious affiliation,
age, sex, disabilities, or sexual orientation.




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INTEREST/AVAILABILITY
What times are you available to volunteer?  Weekday Mornings  Weekday Afternoons
 Weekday Evenings  Weekend Days             Weekend Evenings  Other (please
explain):
                                             ____________________________________


In what area will you be interested in volunteering?
          Outreach Events                                Board or Committee
          Food Pick up/Inventory                               Fundraising
          Food Deliveries/Driver                               Operations
          Transportation                                       Annual Fiesta
          Client Intake                                              Fundraiser
          Dog Walking/Litter Box Cleaning                      Marketing/PR
 Administrative Support
          Graphic Design
          Photography                                    Mailings
          Database Input                                 Pet Services Research
          Front Office Phones                            Website


 OTHER _____________________________________


Why do you want to volunteer with PAWS ?




How did you hear about PAWS?


 Special Event                Internet/Website          Other _______________
 TV/Radio                     Newspaper/Magazine
 Veterinarian                 Friend/Client             Community Referral




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EXPERIENCE

Please share your current and previous experience volunteering:




I certify by my signature below that all of the information given above is true and accurate to
the best of my knowledge, and I further authorize P.A.W.S. San Diego County, Inc. to use
proper channels to verify the same.




Signature                                                   Date




110108
                   P.A.W.S. San Diego County, Inc.
               Confidentiality Hold Harmless Agreement
As a condition of doing volunteer work with the staff or persons receiving services from
PAWS:

I agree not to divulge any information obtained in the course of such work to unauthorized
persons, not to publish or otherwise make public any information regarding persons involved
with PAWS at any capacity. I understand that making any information public is not
permitted at any time. I recognize that unauthorized release of confidential information may
make me subject to civil action.

During the course of volunteering, I may have access to information which is confidential
and may not be disclosed except as permitted or required by law and in accordance with
PAWS policies and procedures. In order to properly care for clients and engage in
successful business planning, certain information must remain confidential. Confidential
information includes, but is not limited to:

    1. Medical and certain other personal information about clients.
    2. Medical and certain other personal information about employees & volunteers.
    3. Reports, policies, procedures, marketing or financial information, and other
       information related to the business of services of PAWS and its affiliates which has
       not previously been released to the public at large by a duly authorized
       representative.

By initialing each section and signing this Confidentiality Acknowledgement, I acknowledge
and agree that:

_____     1. I will only access information for which I have a legitimate business purpose.

_____ 2. Medical information is confidential and my access is restricted to my legitimate
need to know for care of a client/companion animal.

_____ 3. I am obligated to hold confidential information in the strictest confidence and not
to disclose the information to any person or in any manner which is inconsistent with
applicable policies and procedures of PAWS.

_____ 4. My access and use of any information system is subject to routine, random, and
undisclosed surveillance by PAWS.

_____ 5. Failure to comply with my confidentiality obligation may result in disciplinary
action or termination of my volunteering affiliation and it’s affiliates, or corrective action in
conformance with current staff bylaws, rules and regulations.




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_____ 6. Impermissible disclosure of confidential information about a person may result in
legal action being taken against me by or on behalf of that person.


_______7. I also agree to abide by all of the policies and procedures of PAWS and that my
volunteer status can be revoked at any time at the sole discretion of PAWS staff or Board of
Directors.

_______8. I also agree to hold harmless PAWS, the board of directors, and staff in the
event of an accident or injury which results from volunteer work at PAWS.

Volunteer Identification Requirements
_______I understand that in order to participate as a PAWS volunteer, I am required to have a valid
California Driver’s License or equivalent. I agree to inform PAWS promptly if my license is
suspended or revoked or expires. PAWS agrees to keep all and any information regarding your
Driver’s license and its status confidential and further that it may not be disclosed unless required by
a law or a court order.

Volunteer Insurance Requirements
_______If my volunteer participation requires the operation of a motor vehicle, I agree to obtain and
maintain motor vehicle insurance with liability limits which meet or exceed minimum standards of
operation for motor vehicles in the State of California. I agree that I will provide proof of insurance
prior to performing any volunteer activity requiring a motor vehicle. In addition I agree to promptly
notify PAWS should my insurance be canceled or expire. PAWS agrees to keep all and any
information regarding my insurance and its status confidential and further that it may not be disclosed
unless required by a law or a court order.

General and Specific Release from Liability
I acknowledge that I have voluntarily offered my services to PAWS to assist the organization in its
mission to provide essential services to the Companion Animals of low income elderly, the chronically
ill and the disabled. All and any work product that I may perform or provide for PAWS, is performed
on a voluntary basis and is considered a donation of services, performed on a best efforts basis to
facilitate the mission of PAWS. Further, I understand that I am responsible for my own well-being. I
understand and agree that PAWS is not liable for any injury, physical or mental which may occur
during my volunteer service

I further agree and understand that if I am injured while acting as an unpaid member of PAWS staff, I
must depend on my own health insurance to provide compensation and care and that I am not
covered by the California State Worker’s Compensation Law.

In consideration for being permitted to participate as a volunteer for PAWS San Diego County Inc., I
hereby agree that I, my assignees, heirs, distributes, guardians and legal representatives will not
make claim against, sure or attach the property of PAWS San Diego County, Inc. for injury or damage
resulting from negligence or other acts caused, by an employee, agent, or volunteer of PAWS San
Diego County, Inc. I hereby release PAWS San Diego County, Inc. from all actions, claims, or
demands that, my assignees, heirs, distributes, guardians and legal representatives now have or may
have here after, fro injury or damage resulting from participation as PAWS volunteer.

_____________




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Companion Animal Food Delivery

If I have agreed to participate as a Companion Animal food delivery volunteer, I acknowledge that
the duties and responsibilities of that volunteer position have been explained to me. I am aware that
my duties as a Companion Animal food delivery volunteer include, but may not be limited to delivering
Companion Animal food and supplies in my own vehicle, assisting with the Companion Animal food
and supplies in the vehicle of another PAWS volunteer or a PAWS vehicle or in the homes of PAWS
clients, or at various sites where PAWS may retrieve Companion Animal food donations and
contributions.

I acknowledge and understand that delivering Companion Animal food supplies to PAWS clients may
be a potentially hazardous activity. I understand that these hazards may include but are not limited
to, back injury due to lifting, personal injury from accidents, motor vehicle or otherwise, property
damage, damage or injury to others due to an accident, falls, mugging, dog bites or cat bites and
scratches. I acknowledge that other potential hazards may exist and willingly accept the risks of harm
associated with these hazards. I acknowledge and accept these risks of injury, damage or death as
my own personal responsibility, and will not under any circumstance seek recourse against PAWS
San Diego County, Inc., its Board members or staff or volunteers and confirm my complete
agreement by placing my initials here _________.




110108
PAWS San Diego County, Inc.
Pets Are Wonderful Support



                    Volunteer Agreement
The undersigned acknowledges and agrees that:
      That PAWS is not obligated to assign the volunteer to work
      He/she will not contact any of the clients participating in PAWS outside of the PAWS
      program environment and without prior knowledge by PAWS, and he/she will not
      give personal information (address, phone etc.) to any of the clients participating in
      the PAWS programs;
      He/she will complete all screening procedures and training as deemed necessary by
      PAWS, site staff and any authorized staff;

I affirm that the following statements are, to the best of my knowledge, true and complete:

         I understand that the organization respects the confidentiality of client and
         volunteers records.
         I understand that while active as a volunteer in any PAWS program, I am obligated
         to report if there are any changes in my arrest record.

         I understand that PAWS uses photos of volunteers in a variety of activities for
         recruiting and promotional reasons. I am willing to support these efforts. PAWS has
         my permission to use my name and my likeness (photos, images, etc.) to promote
         the agency.

I have read, acknowledged and understand all agreements, statements and requirements of
this document. I HAVE READ AND UNDERSTAND THE CONFIDENTIALITY AGREEMENT,
HAVE HAD MY QUESTIONS FULLY ADDRESSED, AND HAVE RECEIVED A COPY FOR MY
PERMANENT PERSONAL RECORDS.




                                                                                         _
Print Name                                                 Date




Signature




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                             ELDER ABUSE REPORTING
Elder abuse is a term that refers to any knowing, intentional, or negligent act by a caretaker
or any other person that causes harm, or a serious risk of harm, to a vulnerable adult. In
California, anyone age 65 or older is protected by a special set of laws called The Elder Adult
and Dependent Adult Civil Protection Act ("The Elder Abuse Act"), which is a powerful set
of laws designed to help prevent neglect and abuse to California seniors. (Welf & I C 15600
et seq.) Under The Elder Abuse Act, "abuse" is defined broadly and includes any physical
abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment
resulting in physical harm or pain or mental suffering.

Broadly defined, abuse to an older person or senior citizen may be:

         Physical Abuse - Inflicting, or threatening to inflict, physical pain or injury on a
         vulnerable elder, or depriving them of a basic need.
         Emotional Abuse - Inflicting mental pain, anguish, or distress on an elder person
         through verbal or nonverbal acts.
         Sexual Abuse - Non-consensual sexual contact of any kind.
         Exploitation - Illegal taking, misuse, or concealment of funds, property, or assets of a
         vulnerable elder.
         Neglect - Refusal or failure by those responsible to provide food, shelter, health care
         or protection for a vulnerable elder.
         Abandonment - The desertion of a vulnerable elder by anyone who has assumed the
         responsibility for care or custody of that person.

As used in this section, "caretaker" means any person who has the care, custody, or control of
or who stands in a position of trust with an elder or a dependent adult.

I hereby acknowledge that I understand my obligations as a mandated reporter of suspected
elder abuse and agree to fulfill my responsibilities as described above.


____________________________________     ______________________
Signature                           Date

I hereby acknowledge that I have reviewed the elder abuse reporting, mandates
and current agency policies with the above volunteer.

____________________________________                           ______________________
Signature (Volunteer Coordinator)                              Date



110108
PAWS San Diego County, Inc.


                             VOLUNTEER JOB DESCRIPTIONS

San Diego Office Support

PAWS/SD is an all volunteer organization and relies on volunteer assistance for general clerical
assistance. Telephone Interface includes in addition to answering the telephone includes client
problem resolution, animal welfare referrals and general public contact providing information about
PAWS/SD and its services. You must be customer service oriented and have good communication
skills with an emphasis on problem solving. It also includes important activities such as general office
maintenance, file maintenance and the preparation of Client information packages as well as memos,
etc.

Office Support is also needed in the area of computer skills, data entry, graphic design and database
management. Filemaker Pro experience is especially welcomed and competency in Microsoft Word
and excel software programs or equivalent are needed.

Outreach Events

For those weekend warriors, PAWS attends events throughout the year providing information about
PAWS. It includes event set up and tear down and the presentation of PAWS to the general public in
a positive and energetic way. You should enjoy working with the general public at many diverse
events.

Food Pick-Up/Inventory

PAWS often receives contributions of food and litter which needs to be retrieved and taken to the
PAWS warehouse in Vista or San Diego. PAWS receives these donations on an immediate basis
and some scheduled pick ups. You should have an appropriate vehicle for donated food, current
California License and current liability insurance to participate.

Food Delivery/Driver

PAWS provides many clients Animal Food Delivery once a month. In the North County usually Food
deliveries are the second Saturday of each month and in the greater San Diego metro area, usually
the last Saturday of each month. You must have a healthy back and be capable of lifting 40lbs. in
addition you must have a valid California Driver’s License, current liability insurance, and a vehicle
capable of carrying food for delivery.

Companion Animal Transportation

PAWS provides Companion Animal Transportation for the Companion Animals of our Clients to and
from veterinarian appointments. You should have a vehicle appropriate to transport a client and their
Companion Animal, a valid California Driver’s license and current liability insurance. Also you should
have the time available to make a roundtrip with the Client.


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Client Intake

The process to becoming a client involves filling out an application and meeting a list of criteria.
PAWS volunteers then visit the potential client to go over their application and materials with them,
verbally explain the services, and leave reference materials. It also gives us the opportunity to meet
and interact with the potential client and their companion animals!

Dog Walking/Litter Box Cleaning

For those PAWS clients who are medically distressed or disabled, volunteers provide such services
as dog walking and in-home care such as ensuring Companion Animals have food and clean water,
and clean litter. It is an opportunity for those who desire a closer and more personal client and
companion animal connection and experience. You must be able to commit to a consistent visitation
schedule and we request a six month commitment.

Administrative

The front office volunteers work directly with our clients and the public. Client information for food
deliveries, change in status, and vet care needs are inputted, call backs made and clients picking up
food are greeted. You should enjoy working with the public and excellent phone skills.

Mailings consist of folding, stuffing, sealing and labeling a variety of large bulk mailings during the
year. The more volunteers we have helping, the faster we can get things to our donors to generate
funds. The Pawsette Newsletter is sent out quarterly, a holiday campaign letter, and invitations to the
Fiesta del PAWS are the largest mailings.

For the computer-savvy volunteer PAWS needs to constantly update data and resource materials.
These consist of one-time only projects, weekly and monthly updating, or Internet research that can
be done from your home.

Major Event

PAWS’s major fundraising event is the Fiesta del PAWS held in June. Volunteer activities for Fiesta
Del PAWS includes assistance with the pre-event mailings of printed materials, assistance with event
planning, event set-up, cashiering, catering assistance, bartending, security assistance, public
relations, and marketing, and more!




PAWS San Diego County, Inc.
Pets Are Wonderful Support




110108

				
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