Date:____________
Name:__________________________
Address:________________________
City:___________State:_______Zip:____
E-Mail address:____________________
Home#:__________________work#:_______________Cell#:_________________
Age:Young___Over 18, YES____ NO____
In what areas would you like to help:
____Transport ___Transport coordinator
_____Work at Shelter ___Foster ____E-mail ___Fund Raising
___ALL ___ Other
Do you have any obedience training education?_____
Do you have any experience with specific dogs, like puppy mill dogs?______
What hours are you available?___________________________
What, if any, areas of expertise do you have?
___________________________________________
What, if any, shelters have you worked with in the past?__________________
Transporting:
If you choose to help transport, have you had any experience in doing this?_________
Do you own a crate?______ What size? _________
What size dog can you transport?___ Small __Medium____Large
Can you transport cats?_________
Driver's License Number________________
How far can you travel?_________________
Kind of Vehicle?___________________
Color of Vehicle_________Plate#_____________
Have you coordinated a transport before?______
Do you have constant e-mail access?___
Working at Shelters and Fostering:
If you choose to work directly with pets, have you had any experience in doing this?_________
Do you have a quality fence?___ What height?____What size yard?_______
What size dogs can you foster?___Small ___Medium ___Large
Are you able to walk dogs?____
Have you groomed dog before?_____
E-mail or fund raising, have you had any experience in doing this?_____
What type fund raisers have you worked with before?________________________
Have you set up any web pages?___
Do you own a digital camera?_____
Do you belong to any yahoo or rescue group sites?____ If so, which ones? _______________________________
Could you contact businesses for donations of animal supplies?_____
I understand that (I, my daughter, my son) may be working with and around animals. Animal behavior, like human behavior, is not entirely predictable. While recognizing that reasonable precautions are taken to safeguard volunteers, constant supervision is not possible. I will not hold Pet Pals, Inc of Goshen County, nor its' employees, agents and representatives responsible for injuries or accidents which could occur while volunteering. I further indemnify and hold Pet Pals, Inc., its' employees, agents and representatives harmless from any and all injuries, claims, demands, cause of action or damages arising out of my status as a volunteer. I further intentionally, knowingly, and voluntarily WAIVE any and all claims against the above named that may arise out of my volunteering.
By signing this statement, I also agree to pay all attorney's fees and court fees should the Board of Directors of Pet Pals, Inc. of Goshen County, by a majority vote, deem necessary.
________________________
Adult Signature
________________________
________________ _________
Volunteer Signature and Date