Date of completion:

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* 1. Date of completion:

Full Name:

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* 2. Full Name:

Address:

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* 3. Address:

Contact number(s) 

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* 4. Contact number(s) 

Email:

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* 5. Email:

Which BARK programs are you interested in volunteering?

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* 6. Which BARK programs are you interested in volunteering?

What is your availability to volunteer?

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* 7. What is your availability to volunteer?

What interests you about BARK NZ?

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* 8. What interests you about BARK NZ?

How do you think you could contribute to BARK NZ?

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* 9. How do you think you could contribute to BARK NZ?

Will you be joining us with a dog?

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* 10. Will you be joining us with a dog?

If you are volunteering with a dog please complete the following: Will you be using your own dog?

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* 11. If you are volunteering with a dog please complete the following: Will you be using your own dog?

Primary Dogs name:

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* 12. Primary Dogs name:

Primary Dogs Date of Birth

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* 13. Primary Dogs Date of Birth

Primary Dogs Breed (as registered with local council)

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* 14. Primary Dogs Breed (as registered with local council)

Primary Dogs Status (please complete as at application date):

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* 15. Primary Dogs Status (please complete as at application date):

Does your primary dog have any challenges with the following:

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* 16. Does your primary dog have any challenges with the following:

Secondary Dogs Name:

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* 17. Secondary Dogs Name:

Secondary Dogs Date of Birth:

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* 18. Secondary Dogs Date of Birth:

Secondary Dogs Breed (as registered with local council)

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* 19. Secondary Dogs Breed (as registered with local council)

Secondary Dogs Status (please complete as at application date):

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* 20. Secondary Dogs Status (please complete as at application date):

Does your secondary dog have any challenges with the following:

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* 21. Does your secondary dog have any challenges with the following:

Is there any information we might need to know that could impact your ability to work with children?

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* 22. Is there any information we might need to know that could impact your ability to work with children?

Is there any information (medical or otherwise) that could impact your ability to fulfill any BARK duties?

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* 23. Is there any information (medical or otherwise) that could impact your ability to fulfill any BARK duties?

Do you currently volunteer for any other organisations? If so, please list below.

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* 24. Do you currently volunteer for any other organisations? If so, please list below.

Have you ever been asked to leave a position (paid or voluntary). If so, where and under what circumstance?

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* 25. Have you ever been asked to leave a position (paid or voluntary). If so, where and under what circumstance?

Please provide a personal character referee: (Please state name, phone and/or email and relationship)

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* 26. Please provide a personal character referee: (Please state name, phone and/or email and relationship)

Please provide a professional referee: (Please state name, phone and/or email and relationship)

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* 27. Please provide a professional referee: (Please state name, phone and/or email and relationship)

Please provide details for an emergency contact person: (Please state name, phone and/or email and relationship)

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* 28. Please provide details for an emergency contact person: (Please state name, phone and/or email and relationship)

As a BARK NZ volunteer I agree to:

• abide by and support the philosophy, policies, and guidelines of the organisation
• act in the best interests of the organisation
• maintain confidentiality
• abide by safety and risk management requirements
• carry out the tasks outlined in the Role Description
• attend on agreed times and days
• participate in orientation, meetings, and training as required
• maintain a record of my volunteer hours and ensure that information is given/posted the volunteer co-ordinator
• raise any matters of concern with the volunteer co-ordinator or organisation director
• use a warranted, registered and insured vehicle when driving for the organisation
• Notify the organisation of loss of license or driving related charges immediately

BARK NZ agrees to:

• provide information about the organisation
• provide orientation, support, training and supervision
• provide opportunities for input into the organisational plan and evaluation
• reimburse for pre-approved expenses only
• acknowledge and recognise the contribution of volunteers to the organisation

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* 29. As a BARK NZ volunteer I agree to:

• abide by and support the philosophy, policies, and guidelines of the organisation
• act in the best interests of the organisation
• maintain confidentiality
• abide by safety and risk management requirements
• carry out the tasks outlined in the Role Description
• attend on agreed times and days
• participate in orientation, meetings, and training as required
• maintain a record of my volunteer hours and ensure that information is given/posted the volunteer co-ordinator
• raise any matters of concern with the volunteer co-ordinator or organisation director
• use a warranted, registered and insured vehicle when driving for the organisation
• Notify the organisation of loss of license or driving related charges immediately

BARK NZ agrees to:

• provide information about the organisation
• provide orientation, support, training and supervision
• provide opportunities for input into the organisational plan and evaluation
• reimburse for pre-approved expenses only
• acknowledge and recognise the contribution of volunteers to the organisation

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