EASTERN PENNSYLVANIA ANIMAL ALLIANCE
P O Box 123 Sciota PA 18354
VOLUNTEER QUESTIONNAIRE AND AGREEMENT
Eastern Pennsylvania Animal Alliance, established in 2008, is dedicated to bringing together existing forces and talents under one umbrella, to inform, educate, and promote low cost spay and neutering, as a way to reduce homeless pets.
NAME: ________________________________________________ DATE:_____________
____________________________________________________ ZIP __________________
HOME PHONE: (_____)_______________ WORK PHONE: (_____)___________________
CELL PHONE: (______)__________________________
E-MAIL ADDRESS: ____________________________
HAVE YOU EVER BEEN INVESTIGATED FOR OR CHARGED WITH ANY CRIME(S) INCLUDING CRIMES RELATED TO MISTREATMENT OF OR CRUELTY TO ANIMALS? YES NO
What days are you available to volunteer? How many hours a week?
Tell us a little bit about yourself and why you are interested in volunteering for EPAA.
I, _______________________, hereby agree to abide by all the terms and conditions in this questionnaire during
the time I am volunteering as a representative for EASTERN PENNSYLVANIA ANIMAL ALLIANCE.
EPAA will not tolerate any type of harassment including sexual harassment and will take all steps necessary to prevent any and all harassment from occurring. I also agree to refrain from the use of vile, abusive or profane language while serving as a volunteer for EPAA.
1. I will remember in all my dealings with the public that I represent EASTERN PENNSYLVANIA ANIMAL
ALLIANCE as an organization.
2.. I understand all of the above and accept full responsibility for any and all expenses incurred by me during my
tenure as a representative for EASTERN PENNSYLVANIA ANIMAL ALLIANCE.
3. I agree to respond by phone or email to any person/fellow volunteer who contacts me regarding EPAA.
4. I further agree to keep records for EASTERN PENNSYLVANIA ANIMAL ALLIANCE of any paperwork ,
monies collected and expenses incurred for any project or fundraiser in which I participate.
5. I further agree that the EASTERN PENNSYLVANIA ANIMAL ALLIANCE Directors may request to view these
records at any time. In the event I resign, voluntarily or by request of EASTERN PENNSYLVANIA ANIMAL
ALLIANCE, I hereby agree to turn any records/items in my possession to EASTERN PENNSYLVANIA ANIMAL
ALLIANCE within ten days of resignation or request date.
I have accurately completed this questionnaire and agreement, have read all terms and Conditions.
Applicant’s Signature Date
Signature _______________________________________________Date ______________________________