Community Service Volunteer Application

Complete the application on screen, print it, and sign it. Nothing is transmitted from this page.

Dogs we have — it’s people like you we need

Bring or post the signed application to the shelter at 21253 Ringgold Southern Road, Circleville, Ohio 43113, or email it to dogshelter@pickawaycountyohio.gov. Questions: (740) 474-3741. The volunteer FAQ is at the foot of this page.

VIP profile

Date

Name (printed)

Phone number

Street address

City, state, ZIP

Are you 16 years or older?

Yes
No — an adult volunteer (parent or guardian) must join you

Emergency contact

Emergency phone

If a minor, name of parent or guardian

Parent or guardian phone

About you

What is your availability?

What is your animal handling experience?

List any previous volunteer work

How did you learn about the P.C.D.S. volunteer program?

Special roles

What volunteer activities interest you? Check all that apply.

A.M. dog area / kennels cleaning / feeding
Dog exercising
W.I.N. (Wherever I’m Needed)
Outreach & education activities
Assist with events
Help with fundraising
Socialization

Volunteer oath

Check each statement for acknowledgement.

I understand that P.C.D.S. law enforcement duties call for handling confidential and sensitive information regarding animals. If I learn of such, I will preserve its nature to avoid jeopardizing any subsequent hearing or prosecution.
I recognize that P.C.D.S. holds its volunteers and employees to high standards in performing their duties as prescribed and respectfully interacting with others.
I will adhere to the policies, proper practices and directives at P.C.D.S. and not promote any conflicts.
I accept the responsibility to directly disclosing operational incidents-issues to P.C.D.S. management.
I shall fully cooperate with the above obligations or otherwise be subject to involuntary termination.

Thank you for wanting to help the four-legged friends in our care!

Release of liability

In joining the Pickaway County Dog Shelter, as a community service volunteer, I, for myself, my heirs, executors and administrators, waive and release all rights and claims to damages I may have against the Pickaway County Dog Shelter located at 21253 Ringgold Southern Road Circleville, Ohio 43113, or their representatives for any injuries suffered by me while I am a volunteer at the Pickaway County Dog Shelter. I attest that I am physically fit and that a physician can verify my personal health. Should I offer to act as a foster home for any Pickaway County Dog Shelter animal, I agree to assume full legal and financial responsibility for any damage or injury caused by the animal during the time that it is released to my care and supervision.

Print name

Signature

Date

If the volunteer is a minor, print name of parent or guardian

Signature of parent or guardian

Date

For internal use only

Volunteer orientation materials (shelter use)

Orientation Community Service Volunteer Manual

Employee signature — who handed out orientation materials (shelter use)

rev. 8/18

Pickaway County volunteer FAQs

How old do I have to be to volunteer?

16 years or older to volunteer. If a person is under 16 years of age they must be accompanied by adult who has filed a volunteer application.

What do volunteers do?

Walk available dogs, clean kennels, and socialization of dogs.

Can I come in just to play with dogs or puppies?

We are appointment only. Wright-Poling Pickaway County Dog Shelter & Adoption Center is opened six days a week from 11am to 4pm. Closed on all legal holidays.

I have court appointed service hours. Can I fulfill my requirements at the shelter?

Yes. Court appointed and Job and Family Services hours must be scheduled ahead of time.

Should I worry about taking an illness home to my pet?

Always wash your hands and change your clothes before handling any of your own animals. Be sure that your animals are current on vaccinations. Any further questions, please contact your own veterinarian.

Nothing on this page is transmitted to the county. Print it, sign it, and deliver it as the form directs.