Meridian Police Department
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Volunteer Application for the Meridian Valley Humane Society
* Denotes Required Fields
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* First Name:
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* Last Name:
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Address:
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| * Street * City
* State
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How Long at Address:
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Idaho Resident?
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Yes No
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* Home Phone:
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Work Phone:
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* Date of Birth:
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* E-Mail Address:
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* Drivers License Number:
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* State
* Expiration:
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* Drivers License Ever Suspended?
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If yes, please explain
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| Yes
No
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* Have You Ever Been Charged With a Felony Crime?
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| Yes No
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If Yes, Please list date/location/crime:
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* Have You Ever Been Charged With a Misdemeanor Crime Within the Last 7 Years?
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| Yes
No
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If Yes, Please list date/location/crime:
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Current Employer:
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Title:
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Employer Address:
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| Street
City State
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Supervisor:
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Phone:
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* Do you now belong to or have you ever been a member of any group whose aim was to
discriminate against any person because of their race, sex, nationality, or religious affiliations?
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| Yes
No
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If Yes, Please Explain:
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Indicate type of license/permit, such as pilot, radio operator, CCW, etc. Show licensing authority,
where the license was first issued, and the date that the current license expires.
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Special skills and interests, or qualifications:
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What are your volunteer interests?
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Dog Adoption
Dog Walker
Fundraising
Foster Home
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References: Please list three references and contact information:
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* Date:
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I verify that all the information submitted is true to the best of my knowledge.
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