Volunteer Application

First Name (required)

Last Name (required)

Your Email (required)

Phone Number

Street Address

Street Address Line 3

City

State

Zip Code

Date of birth (required)

Height (required)

Weight (required)

Driver's Licence Number and State (required)

Have you ever been convicted of a felony (required)
NoYes

If yes, please provide more details. This will not necessarily disqualify you from volunteering.

If the Volunteer is under 18 years old, This section must be completed

Legal guardian's name

Address, If different than above

Street address line 2

City

State

Zip Code

Email

Best Phone Number

EMERGENCY CONTACT

Contact #1 Name (Required)

Contact #1's Phone Number Required)

Contact #1 Relationship (Required)

Contact #2 Name (Required)

Contact #2's Phone Number (Required)

Contact #2 Relationship (Required)

Medical Insurance

Medical Insurance & Policy Number (Required)

Questions

How did you hear about Headin' Home, Inc? (Required)

What is your volunteer availability? Please specify the day(s) of the week, and time of day. (Required)

How often would you like to volunteer? (Required)
Regularly (more than once a week)Once a weekGroup volunteer opportunityEvents Only

Do you have any impairments or conditions we should know about (hearing, vision, life-threatening allergies, etc)? (Required)

Please list your experience (volunteering, horses, other skills). (Required)

What is your horseback riding skill level? (Required)
Never RiddenBeginnerIntermediateExpert

What is your reason for volunteering? What are your goals? (Required)

Which volunteer activities are you interested in? (check all that apply) (Required)
Feeding & MuckingGroomingWalking horses for exerciseHorse training & gentlingBuilding projects & maintenanceAdministrative tasksEvent help (on-site help)Planning committeesFundraising or grant writingMarketing & public relations

Is there any additional information you think we should know?