Chihuahua & Small Dog Rescue, Inc.

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  Please note:  All questions must be answered.  If not you will not be able to submit this form.  The only two questions that do not need to be completed is the Co-Applicant's signature and date if this is for only one person.
Name:
Email Address:
Address
City, State, Zip
Home Phone
Cell Phone
Work Phone
May we call you at work? Yes
No
Work Schedule
When are you available to transport? Week Days
Evenings
Weekends
Anytime
Type of Vehicle?
Driver's License Number?
Are you willing to pickup from a shelter? Yes
No
How far are you willing to drive?
Do you have a valid driver's license and state minimum insurance Yes
No
Will you agree not to bring your own dog (s) on a transport? Yes
No
Do you agree to crate each dog in a separate crate during transport? Yes
No
If needed (which would be rare), you be willing to keep the dog (s) over night? Yes
No
Since it is possible for you to have a dog overnight, would you be willing to have a home visit done? Yes
No
Any persons in possession of a rescue dog whether it is just to transport to someone else is required to sign a foster contract. Would you be willing to sign a foster contract? (Signing a foster contract does not obligate you to foster). Yes
No
Do you agree to leave small children home during a transport? Yes
No
N/A
The undersigned (hereafter referred to as "the volunteer") is applying to volunteer his/her services to Chihuahua & Small Dog Rescue, Inc (hereafter referred to as CSDR"). By checking the appropriate box the volunteer(s) acknowledges and understands that the dogs involved in CSDR's program may be untrained or unhealthy, and that CSDR makes no representation whatsoever regarding the dog's temperament, health (including the presence or absence of diseases transmissible to humans or other animals). I agree
I disagree
By checking the appropriate box the volunteer(s) understand that CSDR makes to representation as to the dogs age, ability, attitude or trainability. I understand
I don't understand
I agree to sign a hold harmless agreement Yes
No
Your signature (by typing in your name it becomes a legal signature).
Date
Co-Applicant Signature(by typing in your name it becomes a legal signature).
Date
 
      © 2005 Chihuahua & Small Dog Rescue, Inc.