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2. West Valley Animal Services Community Service Application
   If you are needing to complete community service hours, please fill out the following form completely.
4. YOUR INFORMATION:
6. First Name*
7. Last Name*
9. Address1*
10. Apartment #
12. City*
13. State*
14. Zip*
16. Phone Number*
17. Date of Birth*
    Date of Birth
18. Are you 18 or older?*

    1. Yes
    2. No
19. Email*
21. Do you have a government issued ID? *

    1. Yes
    2. No
22. Please attach a photo of your government issued ID or Driver's License*
24. Do you have any allergies? *

    1. Yes
    2. No
25. If yes, please explain:*
27. Do you have any pets at home?*

    1. Yes
    2. No
28. If yes, what kind? *
30. Have you ever worked for West Valley City?*

    1. Yes
    2. No
31. If yes, please explain:*
33. Do you have any experience working with animals?*

    1. Yes
    2. No
34. If yes, please explain:*
36. Some tasks performed by volunteers include lifting, bending, or carrying heavy supplies as well as handling, grooming, or moving large animals. Some volunteer positions require the ability to safely return animals to their appropriate kennels and to read kennel cards. Volunteers must be alert at all times while working around unpredictable and dangerous animals. Is there anything that would prevent you from performing any of the aforementioned tasks?*

    1. Yes
    2. No
38. If yes, please explain:*
40. Have you ever been convicted of any violation of the law?*

    1. Yes
    2. No
42. Why are you being required to do community service? *Violation must be filled in**
44. How many hours are you required to do? *
45. When must the hours be completed by?*
    When must the hours be completed by?
47. Have you been required to complete community service in the past? *

    1. Yes
    2. No
48. If yes, please explain:*
52. EMERGENCY CONTACT:
54. First Name*
55. Last Name*
57. Address1*
58. Apartment #
60. City*
61. State*
62. Zip*
64. Phone Number*
65. Relationship*
69. SCHEDULE:
71. Please select the day(s) and time(s) that you would like to come in:
73. Monday

    1. 8:00am - 10:00am
    2. 10:00am - 12:00pm
    3. 12:00pm - 2:00pm
    4. 2:00pm - 4:00pm
    5. 4:00pm - 6:00pm
74. Tuesday

    1. 8:00am – 10:00am
    2. 10:00am - 12:00pm
    3. 12:00pm - 2:00pm
    4. 2:00pm - 4:00pm
    5. 4:00pm - 6:00pm
75. Wednesday

    1. 8:00am – 10:00am
    2. 10:00am - 12:00pm
    3. 12:00pm - 2:00pm
    4. 2:00pm - 4:00pm
    5. 4:00pm - 6:00pm
76. Thursday

    1. 8:00am – 10:00am
    2. 10:00am - 12:00pm
    3. 12:00pm - 2:00pm
    4. 2:00pm - 4:00pm
    5. 4:00pm - 6:00pm
78. Friday

    1. 8:00am – 10:00am
    2. 10:00am - 12:00pm
    3. 12:00pm - 2:00pm
    4. 2:00pm - 4:00pm
    5. 4:00pm - 6:00pm
79. Saturday

    1. 8:00am – 10:00am
    2. 10:00am - 12:00pm
80. Sunday

    1. 8:00am – 10:00am
    2. 10:00am - 12:00pm
84. Social Media Agreement
    The following are guidelines are for staff and volunteers who participate in social media. Social media includes personal blogs and other websites including Facebook, classifieds online or otherwise, Twitter, Instagram, YouTube etc. The following guidelines apply to staff and volunteers posting or commenting on any sites: 1. Follow all applicable West Valley Animal Service policies (attached). For example, you must not share confidential or proprietary information about West Valley Animal Services. 1. Among the policies most pertinent to this discussion are those concerning confidentiality, government affairs, mutual respect, political activity, computer, e-mail & internet use, photography and video, or release of shelter information to the media. 2. Write in first person. Where your connection to West Valley Animal Services is apparent, make it clear that you are speaking for yourself and not on the behalf of West Valley Animal Services. 3. If you identify your affiliation to West Valley Animal Services, your social media activities should be consistent with WVAS’s high standards of professional conduct. 4. If you communicate on West Valley Animal Services or WVAS -related matters, you must disclose your connection with West Valley Animal Services and your role at the shelter. 5. Be professional, use good judgment and be accurate and honest in your communications; errors, omissions or unprofessional language or behavior reflect poorly on West Valley Animal Services. 6. Respect proprietary information, content and confidentiality when discussing shelter employees, shelter partners and the community. This includes confidential information on the citizens of WVAS, impound specifics, internal policies and procedures. 7. West Valley Animal Services does not endorse people, products, services or organizations. On social media websites where your affiliation to West Valley Animal Services is known, personal recommendations or endorsements should not be given or requested. 8. Unless approved by West Valley Animal Services management, your social media name, handle and URL should not include West Valley Animal Services’ name or logo.
86. Accept Below*

    1. I have read and agree to the Social Media Agreement
90. Although every attempt will be made to ensure your safety, animals are, by their nature unpredictable in behavior. Accordingly, you, as a volunteer agree to the following conditions:
    I hereby agree to hold West Valley City Animal Services, its officers, directors, employees, and other volunteers forever harmless from any and all liability, claims, demands, or causes of action which may arise from performing voluntary animal care and office tasks on a routine basis, and for any injury whatsoever that I may suffer as a result of my volunteer activities with West Valley Animal Services-including, bites, scratches, exposure to communicable illnesses, and exposure to pests contracted from any animal.
92. I verify that by my signature below that the above information is true to the best of my knowledge and I have read each of the above statements and agree to be bound by them. I understand that failure to comply with these guidelines could result in the termination of my volunteer service at WVAS.
94. Applicant Signature*
95. Today's Date*
    Today's Date
97. If the applicant is under the age of 18, I am a parent or legal guardian of the volunteer applicant and I agree to allow him/her to be bound by the conditions represented above.
99. Parent/Guardian Signature*
100. Today's Date*
     Today's Date
Leave This Blank:


102. 1. Receive an email copy of this form.
103. Email address

     This field is not part of the form submission.

104. Submit

* indicates a required field