Volunteer Application Become a Volunteer "*" indicates required fields Name First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home Phone*Cell PhoneEmail* How did you hear about Community Animal Treatment Center?About YouDate of Birth** MM slash DD slash YYYY Gender Female Male EducationPlease select your highest completed level of education. Some High SchoolHigh SchoolSome CollegeVocational / Trade DegreeAssociate DegreeBachelor's DegreeMasters DegreeDoctoral DegreeCredentials Certified Veterinary Technician (CVT) Licensed Veterinary Technician (LVT) Registered Veterinary Technician (RVT) Doctor of Veterinary Medicine (DVM) Doctorate (Non-medical) Medical Doctor Skills & ExperienceIn which of these areas do you feel you have moderate to excellent skill?Please check all that apply. Animal Care Photography Graphic Design Event Planning Public Speaking Fundraising Trap-Neuter-Return Administrative Support Marketing Videography Maintenance (Painting, Handyman) LanguagesPlease select any language that you can read, write, and speak fluently. Spanish Korean Tagalog Armenian Mandarin or Cantonese Other More about you...Please tell us more about the skills and experience that you'd like to contribute to FixNation.AvailabilityDay of Week*Please select any days that are convenient for you. Our clinic is open Wednesday-Saturday from 7am-5pm, but there are volunteer opportunities outside of these days and hours. Monday Tuesday Wednesday (Clinic Open 7am-5pm) Thursday (Clinic Open 7am-5pm) Friday (Clinic Open 7am-5pm) Saturday (Clinic Open 7am-5pm) Sunday Specific Days/Times/Opportunities*Please select any times that are convenient for you. Our clinic is open Wednesday-Saturday from 7am-5pm, but there are volunteer opportunities outside of these days and hours. Monday - Tuesday (Outreach) Wed - Sat, 9am-12pm (Clinic Assistant) Weekends (Events) Frequency*Please let us know how frequently you'd like to volunteer with FixNation. Selecting a frequency here does not commit you to any set time to volunteer. Daily Weekly Bi-Weekly Monthly Project Volunteer Specific Volunteer OpportunitiesFixNation has the following specific volunteer opportunities available.*Please check any that you are interested in assisting with. Educational Tabling Temporary Foster Transport Submitting this applicationAgreement*I understand and agree that submitting this application form does not automatically register me as a FixNation volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. By submitting this form, I attest that the information I have provided on the form is true and accurate. I agree. CommentsThis field is for validation purposes and should be left unchanged.
