Community Service ApplicationPlease complete the form below, and we will be in touch with available community service hours. Legal Name * First Name Last Name Email * Phone * (###) ### #### Drivers License Number * Age * Although we do allow minors to complete their community service at the adoption center, if under 16 years of age, a parent or trusted adult must remain at the location with the minor while they complete their hours. Minors may not assist at the thrift stores. Type of Infraction/Offense Resulting in Community Service * Date of Infraction/Offense * State and County in Which Infraction/Offense Occured * How many total hours do you need? * At which location do you wish to do your community service? Adoption Center (Titusville) Titusville Thrift Store Melbourne Thrift Store Please specify your availability (hours/days of the week) for completing your community service hours in the field below: * If under 18, please provide contact information for parent/legal guardian: Please read carefully before checking the box and submitting your application: I understand and agree that submitting this application form does not automatically register me as an SPCA of Brevard Community Service Worker and that there may be certain qualifications I must meet, including the acceptance of established policies and procedures before I begin. I understand that I will not be allowed to handle animals at the SPCA unless specifically asked to by staff and that the bulk of my community service will be geared toward cleaning kennels and general upkeep of the adoption center. By submitting this form, I attest that the information I have provided on the form is true. I agree to hold harmless the SPCA of Brevard, its employees, directors and insurance carriers from any and all claims, damages and judgements which I may have now or in the future against the SPCA of Brevard in all matters pertaining to my service as an SPCA of Brevard Community Service Worker. I agree Thank you!
