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2. Electronic Signature*

   By checking the "I agree" box below, you agree and acknowledge that:

   
   

   1) your application will not be signed in the sense of a traditional paper document.

   
   

   2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature

   
   

   3) you may still be required to provide a traditional signature at a later date. 

   1. I Agree
6. Is your interest in volunteering for NACC in order to gain pre-court date community service hours or Court ordered community service hours?*

   1. Yes
   2. No
10. Legal First Name*
11. Legal Last Name*
13. Preferred Name: *
14. Email Address:*
16. To volunteer onsite, a minor must be 16 or 17 years old with a Parent/Guardian volunteering alongside.
17. Date of Birth:*
    Date of Birth:
19. Current Address: (No PO Boxes)*
21. Apartment or Unit #
22. City*
24. State*
25. Zip*
27. Primary Phone Number:*
28. Secondary Phone Number:
32. By signing the box below, you agree and acknowledge that:*

    I attest that I have never been charged with or convicted of animal cruelty, neglect, or abandonment.

    
    

    I acknowledge that my application does not guarantee placement into the volunteer program and that falsifying any information on this form will immediately disqualify me from volunteering at NACC.

    
    

    The Norfolk Animal Care & Adoption Center can deny any applicant/application. I acknowledge that my application, attending the volunteer orientation, and/or starting the on-boarding process does not guarantee placement into the volunteer program.

    
    

    I acknowledge that my volunteer services are strictly voluntary, without pay or compensation of any kind, and without liability of any nature on behalf of the Norfolk Animal Care & Adoption Center (NACC)

    
    

    I acknowledge that NACC does not guarantee the temperament, behavior, or health of any shelter animal.

    
    

    I acknowledge that falsifying any information on this form will immediately disqualify me from volunteering at NACC.

    
    

    I acknowledge that if a minor is 16-17 years old then a parent/legal guardian must volunteer alongside.

34. Parent/Legal Guardian Signature (Legal First and Last Name)

38. NEXT STEP - Once you have submitted your application it will be reviewed by our Volunteer & Community Engagement Coordinator. If approved, they will be in contact with you about upcoming orientation dates. 

    Have questions? Need additional assistance? Reach out to the Volunteer & Community Engagement Coordinator at volunteernacc@norfolk.gov

Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field