Please fill in EVERY field - Enter N/A when not applicable
|
If you do not get a confirmation number, then you did not fill in a REQUIRED field. Look the words "Invalid Input!" on the page (it will be in RED), fill in the missing information and submit the application again.
|
SECTION 1
|
| Today's Date:* | |
| How did you hear of us?* | |
| Full Name:* | |
| Address:* | |
| City:* | |
| State:* | |
| Postal Code:* | |
| If in a rural locale, the nearest major city: | |
| Preferred EMail Address:* | |
Phone Number with area code:
|
| Home:* | |
| Work:* | |
| FAX: | |
Please choose the appropriate age category:
(if under 18, you must have a parent/guardian's consent)
|
| Age: | |
What type of work are you interested in performing for BP&SBR?
|
| Fostering | |
| Breed of interest for fostering (or enter ‘any’): | |
| Transporation | |
| Distance willing to travel: | |
| Adoption Interviews and Home Visits | |
| Contacting new adoption applicants | |
| Contact person for new volunteer/foster applicants | |
| Fundraising | |
| Contact for shelters and other rescue organizations | |
| Work at the Rochester adoption center | |
What Humane Society or SPCA are you located near and do
you have an established relationship with them? If yes, explain. | |
Please provide 2 personal (non-relative) references that we may contact:
|
Reference 1:
|
| Name: | |
| Relationship: | |
| Phone: | |
| Email: | |
Reference 2:
|
| Name: | |
| Relationship: | |
| Phone: | |
| Email: | |
|
| Do you currently own any dogs? | |
| Please provide breed, sex{es}, age{s} and name{s} of your dogs: | |
| Do you currently own any other pets? | |
| Please provide species, sex{es}, age{s} and name{s} of your pets (if appropriate): | |
| Do you support spaying and neutering of pets? | |
| Are your pets spayed/neutered? | |
| If your pets are not spayed/neutered please explain why they are not. | |
| Have you ever bred your pets? | |
| If you have bred your pets please tell us when and why. | |
| Do you plan to breed your pets in the future? | |
| Are your pets up to date on shots and heartworm prevention? | |
| Have you owned animals in the past not listed above? | |
If yes, what became of them?
|
| Ran Away | |
| Stolen | |
| Sold | |
| Lost | |
| Given Away | |
| Surrendered to shelter or rescue group | |
| Euthanized | |
| Died | |
| Other | |
| Please state the reasons behind your above choice: | |
Please check to indicate that you are aware
that you must keep BP&SBR up-to-date in the
event the number or status of your household
pets should change?* | |
IF NOT INTERESTED IN FOSTERING, PLEASE SKIP TO SECTION B AND/OR C
|
A. INFORMATION FOR FOSTER PARENTS
|
| Tell us about your household and why you choose to foster a dog: | |
| Have you previously fostered for any shelter or rescue organization? | |
If yes, then please supply details:
What shelter or rescue group and the particulars: | |
| Are you willing to permit a home check by a BP&SBR representative? | |
| Long range plans within the next year as it relates to fostering. | |
| TELL US ABOUT YOUR RESIDENCE: | |
| Type of household: | |
| If renting please provide landlord's information: | |
| Please indicate the description that best suits your residence. | |
| Type of fence and size of fenced area: | |
| Size of living area: | |
| If there is not a fenced yard, will you provide leashed walks: | |
| How do you plan to housebreak the dog if it's not already housebroken? | |
| Are there any children in your household? | |
| Number of children: | |
| Ages of children: | |
Please list the names and ages of all co-habitants or
others who frequently share your premises and/or fenced yard | |
| Are all members of your household aware that you will be fostering? | |
| Do they all approve? | |
| How many hours a day will the dog be left alone?* | |
Where will the dog be kept when alone?
(please be specific i.e. crate, room, run of house etc.) | |
| Where will the dog be kept during the day?: | |
| Where will the dog be kept during the night?: | |
| Where will the dog be kept when the family is home?: | |
If there is any aspect of your home that a puppy could affect?
(white carpet, antiques etc.) please identify: | |
| What is the level of activity in your household? | |
| Are you away for extended periods? | |
| If so will you : | |
If you have children in the household,
how much of the responsibility will your child be given
for the care and management of the dog? | |
How much adult supervision will be
provided when the dog and child are together? | |
If there are no children in your household,
how often will the dog come into contact with children? | |
| How many interactions will the animal have with visitors? | |
| Tell us the type of dog you would prefer to foster: | |
What kind of food do you plan to feed your dog and
what is your feeding plan? | |
Are you willing to foster an animal that has special needs?
(health, diet, training, other) | |
| If yes, any health problems not accepted? | |
| Are you willing to groom an animal? | |
Are you willing to take a dog to obedience training or
help with behavior modification? | |
How would you encourage or reinforce the foster dog's
appropriate {good} behavior? | |
Are you prepared to keep the foster dog for an
indefinite period of time until the dog can be
placed into an approved home? | |
Are you willing to abide by the rules of BP&SBR,
in that no medical care shall be done without prior
written approval from the BP&SBR Committee with the
exception of emergency care? Do you understand that
you must notify the Committee at the first available
opportunity after emergency care and all original
receipts must be submitted to the treasurer before
being reimbursed? | |
Do you understand that upon taking a foster dog that
the dog in your care will be up for adoption and when
an appropriate home is found the dog will be transported to its
new home and further that while the fosterer's opinion of
the dog is given serious consideration, when placing the
dog in a permanent home, the final decision regarding
the placement of the dog will remain solely in the decision
of the Committee. Should you decide that you want to adopt
the dog while it is in your care, you are required to submit
an Adoption Application and, after approval, complete an Adoption
Contract and make the appropriate donation. If you find that
a specific foster does not work for you in your home, you are
to notify BP&SBR immediately.
| |
B. VOLUNTEER INFORMATION
|
Please indicate that you are now aware that
your application must be approved before are enlisted
as a BP&SBR volunteer and/or foster? | |
Do you work with any other rescue groups who we can
contact for a reference? If so, please list group(s)
and contact information: | |
Vet and complete phone number: (Note: Please
advise your vet that we will be calling to obtain
any information on the care of your pets) | |
Additional Information and/or Comments:
C. INFORMATION FOR TRANSPORTERS
|
| What is the closest airport to you? | |
What is the closest major city to you?
Please list the miles/km | |
| What type of vehicle do you drive? | |
| Do you have crates available? | |
Once you have filled out and returned this Volunteer Application,
a BP&SBR volunteer will contact you regarding the status of your
application. If approved, a copy of the BP&SBR Code of Ethics for
Fostering & Rescue Volunteers will be sent to you for your signature.
|
Please indicate whether you have read the entire application and
understand it's meaning and agree to it's terms by clicking the button below.
|
Neither this Application nor any other document, undertaking or agreement
to be delivered by the undersigned furnished to BP&SBR in connection with
this Application contains or will contain any untrue statement of fact or
omits or will omit to contain a fact necessary to make any statement not
misleading. There has been no event or information not disclosed in writing
to BP&SBR which could reasonably be expected to have an adverse effect on
the health, comfort, safety or well-being of the subject dog.
|
I, the undersigned, hereby certify that all statements made herein make
full disclosure and are true. Should there be any change in the circumstances
as stated above, I undertake to notify BP&SBR as soon as possible.
|
| Do you agree to the above terms? | |
APPLICATION SUBMISSION GUIDELINES
All fields must be completed before submissionPress the submit button only onceYou will receive a confirmation number upon submission.Save this for future reference/correspondence.
Thank you again for your interest in volunteering to help BP&SBR.
|
| |
Home 
Applications 
Members 
About Us 
Rescues 
Resources 
Admin 
members: 5112
guests online: 13
members online: 0
You are an anonymous user. You can register for free by clicking 
Surrender Application 
My Account 
Contact Us 
Search