Siskiyou Humane Society 1208 N. Mount Shasta Blvd. P.O. Box 484 Mount Shasta, California 96067

Please state any previous animal care of animal related experiences you have had:

Volunteer hours: Shelter: 1 to 4pm Mon thru Sat -Thrift stores - Mount Shasta: 11 to 4 M-Sat,
Yreka: 10 to 4 Tues-Fri, 10-2 Sat

What are your primary areas of interest:

Do you have any special skills you would like to share with us?

Advertising__ Computer__

Education__ Yard Work__

Art/Design__ Finance__ PR/Adv__

Legal/Gov__ Appliance Repair__ Entertainment__

Grants__ Photography__ Clerical__

Construction__ Maintenance__ Other__

What do you think you can contribute to the Humane Society? What makes you unique, and an asset as a volunteer?
______________________________________________________________________

What would you like to get out of your participation in S.H.S volunteer programs?
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Please list two references (Community leaders, business owners, S.H.S Board members)________________________________________________________

I have read the Volunteer Policy Statement and Mission Statement of the Siskiyou Humane Society and I agree to support the ideas expressed therein in my service with the Society. I also agree to abide by all of the Siskiyou Humane Society's safety and service procedures.

Signature_______________________________________ Date_________________________