Northern Chesapeake
Sheltie Rescue

Volunteer Application

Northern Chesapeake Sheltie Rescue is a non-profit organization dedicated to the rescue and care of Shetland Sheepdogs in need of a permanent, loving home. We are staffed entirely by volunteers who give their time and effort to providing a better life for dogs who need our help.

If you would like to share in this effort, please fill out this form and submit it. We will contact you shortly regarding the activities in which you have expressed an interest.

Name:

Address:

City/ State/ Zip:

Home Phone:

Work Phone:

Email Address:

Occupation:

How did you hear about us?:

How many hours are you available per week for rescue activities?

Have you volunteered in the past for any other rescue groups or animal control agencies?
YES NO
If Yes, give the name of the group or agency and describe your role.

Please describe any experience or skills related to rescue:

Please give any other information that you feel is relevant to your desire to work in dog rescue:

Please fill out any areas of volunteer work that you think you would be interested in.

FUND RAISING

Interested Not Interested

As a Non-profit organization, all of our income is derived from donations. We hold many fund raisers during the year and volunteers are needed to work these events. This would require you to travel to the location where the event is being held, work the hours you have signed up for, and help with setting up and clean-up afterward. This also requires direct interaction with the public and the ability to promote our rescue group.

	Do you have a vehicle or other means of getting to/from fund raising events?
	Are you available on weekends?
	Do you enjoy working with the public?

REFERENCE CALLS

Interested Not Interested

All prospective adopters must provide three personal references and a vet reference. Volunteers are needed to call and check out these references and report back to the group. Some of these calls take time and may incur phone charges.

	Do you feel comfortable calling people and inquiring about prospective adopters?
	Do you have access to a telephone during both days and evenings?
	Do you have an answering machine or voice mail to receive returned calls?

TRANSPORTING DOGS

Interested Not Interested

Some dogs adopted through our organization will need to be transported to a foster home. This will require travel to/from the transport locations, which can possibly incur gas and toll costs. It also requires putting a strange dog in your vehicle, so a crate or confined area is recommended. Sometimes the dog will experience motion sickness or other events that could make a mess in your vehicle.

	Do you have a vehicle to travel to/from transport locations?
	Do you have a crate or other means to restrain the dog in your vehicle?
	Do you object to having a strange dog in your vehicle?
	Do you object to a dog soiling your vehicle?

FOSTERING

Interested Not Interested

Often, dogs in imminent danger need to be pulled from shelters or abusive situations before an appropriate adopter can be found. When this happens, we rely on volunteers to provide a temporary home for these dogs. In order to become a foster home, please continue with the foster application portion of this form.

If you do not want to apply to be a foster home, press the NOT INTERESTED button, then please scroll to the end of the foster volunteer section and continue with the rest of the volunteer application.

Please list three references: name, phone number and relationship

Do you own or rent your residence?
OWN RENT

If you rent, you MUST submit written permission from your landlord stating that you are allowed to have a dog.

Do you currently have homeowner's or renter's liability insurance?
YES NO
If yes, please provide a copy of your insurance policy.

How many people live in your household?
Do you have children?
YES NO
If yes, list ages of children

Do you have any other pets?
YES NO
If yes, list types of pets and how long you have had them.

If you own pets, please provide the name and telephone number of your current veterinarian.

Do your current pets have any issues with other dogs entering the household? YES NO
If yes, please explain:

Do you have a fenced yard?
YES NO
If yes, please describe type of fence and approximate size of yard.

If no, how do you plan to provide exercise for the dog?

Do you own a crate?
YES NO
If yes, please describe type and size of crate.

Do you have an area in your home where a foster dog could be secluded in the event that there is a problem with other pets or family members?
YES NO
If yes, please describe area.

How many hours per day would the dog be left alone?

Do you understand that dogs may be unpredictable and that Northern Chesapeake Sheltie Rescue cannot guarantee that a dog we place with you may not become aggressive?
YES NO

Are you willing to assume the risks associated with working with animals who are sometimes frightened and who, in unfamiliar surroundings, may become aggressive and/or bite you or a companion?
YES NO

What type of vehicle do you have for transporting dogs?

Are you willing to accept the risks involved, including damage, with transporting a dog inside your vehicle?
YES NO

Are you willing to accept the risks involved, including damage, with having a foster dog in your home?
YES NO

End of Foster Volunteer questionnaire section, Please continue with the rest of the application.

PLEASE READ THE FOLLOWING CAREFULLY AND FULLY BEFORE SIGNING:

  
I agree to abide by the following terms as a volunteer and representative of Northern Chesapeake Sheltie Rescue:

(1) I will not sell or give away any dog in my care to a research facility, pet shop, dog broker or puppy mill, or to any other person, firm or corporation that may cause harm either mental or physical to any dog.

(2) I will not use any dog that comes into my care through rescue for breeding purposes of my own or allow it to be used by any other person for those purposes.

(3) I will remember in all my dealings with the public that I represent Northern Chesapeake Sheltie Rescue and will act pleasantly and answer questions politely, or refer persons to someone who can.

I understand all of the above and accept full responsibility for any and all expenses incurred by me during my tenure as a volunteer for Northern Chesapeake Sheltie Rescue.  I agree that any application, release or adoption forms and contracts, as well as moneys collected from donations and fees are the property of Northern Chesapeake Sheltie Rescue and shall be returned to Northern Chesapeake Sheltie Rescue within seven days of my receiving them.  I further agree that in the event that I resign, voluntarily or by request, I will return any rescue dog records that I may still have to Northern Chesapeake Sheltie Rescue within 10 days.

I have accurately completed this questionnaire and appreciate the risks in working with rescue dogs.  I understand that Northern Chesapeake Sheltie Rescue cannot be responsible for the actions, behaviors and/or medical conditions of the dogs that it seeks to rescue, and I agree to assume the risks implicit in working with dogs which may have been abandoned, beaten or otherwise mistreated or abused, or who may suffer from an illness, condition or disease.  Further, I agree to indemnify and hold harmless Northern Chesapeake Sheltie Rescue, its members and representatives, against any and all claims, known or unknown, now or hereafter, for any injury or damage to property or persons caused by or related to any rescue dog that I may come in contact with, and agree to take  any and all necessary precautions to prevent any such injury or damage.

I understand that my electronically-generated signature below is valid as a means of legal signature for the purpose of this volunteer application YES

Signature of Volunteer:

Date: