|
Name:
|
|
|
|
|
Check here to confirm that
you are over 18 years old
|
|
|
|
|
|
|
|
|
|
|
|
Email:
|
|
|
|
|
|
|
|
Home address
|
|
|
|
|
|
|
|
|
|
|
|
Cell #:
|
|
|
|
|
|
|
|
|
|
|
What are you applying for? (check as many or as few as you like
|
|
|
|
Foster Home
Transporter
Pull dogs
from shelters
|
|
|
Public Relations
Office help
Other (please
specify)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TRANSPORT VOLUNTEERS
If you are not applying to be a transporter,
please scroll down to the next section
|
|
|
|
What is the geographic range you are willing
to drive? (i.e., NE Ohio - NW Penn only, etc.)
|
|
|
|
|
|
|
|
Car
model/make/year:
|
|
|
|
|
|
|
What is the maximum # of
dogs you can fit in the car:
|
|
|
|
|
|
|
What types of restraints do you
use for the dogs in your car?
check all that apply
|
|
|
|
Crate
Harness/seat belt
|
|
|
|
|
|
None
Other (please specify):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Are there any restrictions on days
and times you can transport?
|
|
|
|
|
|
No
|
|
|
|
Yes, please specify
|
|
|
|
|
|
|
|
|
|
|
If there are any other restrictions
(i.e., no intact males, no wolfdogs,
no females in heat, etc.),
please list them here:
|
|
|
|
|
|
|
Will anyone be traveling with you?
|
|
|
|
|
|
No
|
|
|
|
Yes
|
|
|
|
|
|
|
If yes, please list the co-transporter's
name, email address, and cell phone #:
|
|
|
|
|
|
|
|
FOSTER HOME VOLUNTEERS
If you are not applying to be a foster home,
please scroll down to the next section
|
|
|
|
Do you rent or own
your residence?
|
|
|
|
Own
|
|
|
|
Rent
|
|
|
|
|
|
|
|
If you rent, check here to
confirm that your landlord
would allow you to foster a dog
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
How many people live with you?
|
|
|
|
|
|
|
|
Tell us about the people in your home (including yourself)
|
|
|
|
Your age & gender:
|
|
|
|
|
|
|
2nd person's age, gender & relationship to you:
|
|
|
|
|
|
|
3rd person's age, gender & relationship to you:
|
|
|
|
|
|
|
4th person's age, gender & relationship to you:
|
|
|
|
|
|
|
If there are more individuals who share your
home, please list their ages, genders, and
relationships to you:
|
|
|
|
|
|
|
This may not seem relevant, but some dogs are fearful of children or men (and some are
simply too rambunctious for toddlers or the elderly). So for the safety and security of both
the dogs and the families, we need to know ages and genders of everyone in the home.
|
|
|
|
|
|
Check here if you currently have
dogs of your own
|
|
|
|
|
|
|
|
|
|
|
List the breed/mix, age, gender of your dog(s):
|
|
|
|
|
Are your dogs spayed/neutered?
|
|
|
|
|
|
|
|
|
Yes, all are spayed or neutered
|
|
|
|
No, none are spayed or neutered
|
|
|
|
|
|
|
|
|
Some are. Please specify if your
intact dog is male or female.
|
|
|
|
|
|
|
|
|
Check here only if ALL of your dogs are up to
date on their vaccines: Rabies, Distemper,
Coronavirus, Parvo, Bordetella
|
|
|
|
|
|
|
|
|
Veterinarian's name, clinic name, address, and phone number:
(please note that we will not allow anyone to foster if their dogs are not UTD on
vaccines! This is for the protection of your own dogs too, as we cannot prove that
shelter dogs were actually given any other vaccines besides Rabies)
|
|
|
|
|
|
|
|
Preferred breeds to foster:
Please note that purebreds are rare
in rescue; this list is to specify the
predominant breed in the mix:
|
|
|
|
|
|
|
Is there any breed you don't wish
to foster?
|
|
|
|
|
|
Do you have other
animals besides dogs?
|
|
|
|
No
|
|
|
|
Yes, see info below
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Yes,
Spaye
d/
neuter
ed
|
Yes,
UTD
on
shots
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Have you ever fostered
an animal before?
|
|
|
|
No
|
|
|
|
Yes
|
|
|
|
|
|
|
|
|
|
If yes, please list the name of the
organization complete with
address and phone number;
please include email address and
contact individual (if known)
|
|
|
|
|
|
|
|
If yes, please describe your past
fostering experience (i.e, type of
animal, length of stay, what you
did and how you liked/disliked it):
|
|
|
|
|
|
|
OFFICE HELP, OTHER, & PR VOLUNTEERS
If you are not applying for this,
please scroll down to the bottom to hit the Submit button
|
|
|
|
If applying for OFFICE HELP,
please list any previous
experience (including computer
skills):
|
|
|
|
|
|
|
|
If applying for PR WORK, please
list any previous experience you
have in public relations, public
speaking, and/or outreach and
education:
|
|
|
|
|
|
|
|
If you have any other skills that
you feel might be of benefit to
Husky Havoc RRT, please
describe them here:
|
|
|
|
|
|
|
|
|
|
|
|
|