EmailMe Form - BECOME A TEN LIVES CLUB VOLUNTEER

Name *

First Last

Email *

HOME PHONE *

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CELL PHONE

### - ### - ####

HOME ADDRESS *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

DO YOU HAVE A CAT OF YOUR OWN OR HAVE PREVIOUSLY OWNED A CAT? *

YES

NO

HAVE HAD A CAT IN THE PAST

ARE YOU ALLERGIC TO CATS OR HAVE ANY OTHER ALLERGIES? *

YES

NO

ARE YOU AGE 16 OR OLDER? *

YES

NO

IF YOU ARE NOT AGE 16, DO YOU HAVE A PARENT OR GUARDIAN WHO CAN VOLUNTEER WITH YOU? *

YES

NO

N/A

DATE OF BIRTH *

MM / DD / YYYY

DO YOU NEED COMMUNITY SERVICE HOURS? *

YES

NO

IF SO, CAN YOU COMMIT TO AT LEAST 2 CONSECUTIVE MONTHS OF VOLUNTEERING ON A WEEKLY BASIS? *

YES

NO

N/A

WILL YOU BRING ANY CHILDREN WITH YOU ON YOUR SHIFT? *

YES

NO

IF SO, PLEASE INDICATE AGE(S): *

PLEASE SELECT WHICH DAYS & TIMES YOU ARE AVAILABLE: *

CAN YOU FOSTER A CAT IF NEEDED? *

YES

NO

ARE YOU INTERESTED IN BECOMING A VOLUNTEER STORE COORDINATOR? *

YES

NO

MAYBE

ARE YOU INTERESTED IN BECOMING QUALIFIED TO APPROVE CAT ADOPTIONS? *

YES

NO

MAYBE

WOULD YOU LIKE TO PARTICIPATE IN FUNDRAISERS &/OR ADOPTION EVENTS? *

YES

NO

MAYBE