Workamper Application - Sierra County Humane Society

Desert Haven Animal Refuge (DHAR) operate under the 501-C-3 non-profit umbrella of the Sierra County Humane Society, Inc., a charitable animal welfare organization dedicated to the Prevention of Cruelty to Animals, Relief of Suffering among Animals and Extension of Humane Education in Sierra County, NM.

Personal information

Check one

Mr.
Mrs.
Ms.

Name *

First

Middle

Last

Preferred Nickname: *

Physical Address

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address (if different than physical)

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Cell Phone #1

Cell Phone #2

Primary Email *

Secondary Email

Facebook page(s) 1

Facebook page(s) 2

Website/Blogsite

Employment Status

Current Employment Status for each individual in your work camping party:

Retired
Semi-retired
Other

PLEASE LIST current/on-going income producing activities if any - ie: flea markets, ebay auctions, etc. Do you have your own Ebay, Etsy or other site you currently use as an income producing activity? If so please list here:

Not employed (Please list previous employer / occupation). If you - or anyone in your work camping party - are neither retired nor currently employed, do you plan to secure part-time employment in the surrounding communities while residing at Desert Haven? Elaborate as needed.

Head of Household

Head of Household Name *

Age

Other member:

Name (of others) *

Age (others)

Workamping Details

Have you been a Workamper before?

Yes
No

If yes, briefly describe places, dates, duties etc.

Please Indicate any disability / physical limitations which you believe may or may not affect your activities at Desert Haven. Include: recent surgery, chronic illness, pet allergies, phobias, etc. *

Earliest date(s) you can make yourself available should there be an opening at that time of the year. Month/Day/Year

UNLESS AGREED UPON by all parties involved, we request at the very least two months commitment during the spring & summer months and no less than three months during fall and winter. Longer than three (3) months commitments are highly recommended, as we are looking for continuity within our work camping team in order to keep the non-human residents of the sanctuary from being affected negatively by any turn-over.

How long do you currently wish to commit for?

Work campers who spent several months at a time at DHAR and who plan to return the following year are considered SEASONAL. Work campers who commit to stay at DHAR one year or longer are considered LONG TERM.

Would you consider this commitment?

One-time only
Possibly Seasonally
Possibly Long Term

Feel free to elaborate

Considering that some of our work camping positions often fill up several months to a year in advance, would you consider an opening for other dates in case our positions are filled for the months that you prefer?

Yes
No

Feel free to elaborate

Week-end and Holiday animal care of animal residents will be needed. Will you be available to share this task with other members of the Animal Care Team whenever needed?

Yes
No

RV Details

Please describe your rig:

Motor Home
Fifth Wheel
Travel Trailer
Other

Total length, pullouts, etc.

What kind of hook-up does your rig require?

30 Amps
50 Amps
Other

Does your rig include: (check all that apply)

If other, please explain

Will you have a vehicle (or more) in tow? Elaborate as needed

How Many in your household? Please include all companion animals/birds, etc - (type, breed and name)

Please List any skills, talents, that you believe could be of some help to us during your stay at our sanctuary. Use the “additional comments” section as needed.

Do you prefer to work...

By yourself
On a team
As a leader
As a helper

What do you consider your strongest attributes?

What do you consider your weakest points?

What are your hobbies, special interests?

Describe yourself (please select all that apply)

How do you describe yourself

Which do you prefer

Working Indoors
Working out-of-doors
Office/computer/phone work

Which do you prefer

Working with people
Working with animals (includes all aspects of care for domestic animals)
Both equally

Background information

Have you ever served on active duty with the US Armed Services?

Yes
No

If yes dates of service (from & to), and Branch served

Type of Discharge

Were you convicted or have you ever pled guilty to a felony?

Yes
No

If you answered YES to the preceding question, please explain the circumstances: Use another page if you needed.

Do you consider yourself a:

smoker
non-smoker
social drinker
non-drinker

Elaborate here if you wish

References:

Reference #1 - Please List the names, locations, relationship to you (friend, former employer, a neighbor – No family member. Also include telephone numbers and e-mail addresses of your references.

Reference #2

In Case of Emergency

Emergency Contact *

First

Last

Emergency Phone

Emergency Address

Address Line 1

Address Line 2

City

State

Zip Code

Additional Information

Additional Comments you would like to share:

Please tell us how you heard about us

Please note: work camping positions at Desert Haven require a work commitment of the following hours per week in our animal welfare organization: Single – an average of 17-20 hours/week. Couple - an average of 28-32 hours/week.

Please enclose with this application at least one small, recent digital photo of you and your rig for preview.

Click or drag files to this area to upload. You can upload up to 3 files.

If you find you’re having any issues, uploading your Photographs Please skip that part and feel free to email the photo to this address dhanimalrescue@gmail.com

Signature Head of Household

Signature of Spouse/Partner/Companion/Significant-other (if your duties will be shared with that person):

Date

Workamping Application

Personal information

Employment Status

Head of Household

Other member:

Workamping Details

RV Details

Describe yourself (please select all that apply)

Background information

References:

In Case of Emergency

Additional Information