Pals For Life

To find out how you can help
Click Here
for donation information

Pals For Life Volunteer Registration

Pals For Life Volunteer Registration Form

Thank you for your interest in becoming a Pals For Life volunteer! Please fill out the following form. When you are finished, click on 'Submit' at the bottom of the page to send the form directly to us. Be sure to include your phone number, address, and email, so that we can contact you. Thanks again....we look forward to hearing from you!

* Your Name:

* Address 1:

Address 2:

* City:

* State:

* Zip Code:

* Email Address:

* Home Phone:

- -

Work / Cell Phone:

- -

Best Time to Contact:

Morning
Afternoon
Evening

Programs you are interested in:

Visitation Programs
Education Programs
Writing
Benefit Committee
Special Events
Typing, Office work, etc.
Other (please specify):

Times available:

Days Evenings Weekends

Can you provide your own transportation?

Yes No

If "no," do you have access to public transportation?

Yes No

Do you have experience with pets?

Yes No

If "yes," what types of pets?

Do you have a pet you would like to bring to pet programs?

Yes No

If "yes," please fill in the following:

Type of Pet:
Breed:
Name:
Age (years):

Are you allergic to any pets?

Yes No

If "yes," please specify:

Do you have any medical restrictions?

Yes No

If "yes," please specify:

How did you hear about Pals For Life?

Are you a United Way donor? Now you can choose to designate your contribution to support Pals For Life! Click here for details!