Volunteer / Foster Application

All Fields MUST BE completed.. Please allow 1 -3 weeks for your application to be processed. Please contact your vet promptly after sending this form to allow LPR Inc. permission to obtain a vet check

First Name

Last Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Cell Phone :

Email Address

Date of Birth

GENDER

Emergency Contact ( If hands on Volunteer)

Phone Number of Emergency Contact:

Name of Current Vet:

Please Provide Names,Phone Number and Email Address of THREE (3) References: NO Relatives please.. {Phone #'s MUST be provided}

Reference # 2

Reference #3

Education Level

Name of High School

Name of College

College Major

Name of Employer

Hours Worked

Does anyone in your family have any skills, hobbies, talents, etc, that they may want to volunteer at LPR

Why are you interested in volunteering at Lil Paws Rescue (LPR)

Please describe any previous volunteer experience

What are your areas of interest?

Are you available on a regular schedule each week?

Please list what hours you are available

Are you a valid licensed and insured driver?

Are you willig to use your car to transport people or animals as part of your volunteer work?

Have you ever been convicted of a crime? If YES please explain

Are you volunteering to meet mandatory requirements for

SCHOOL

CHURCH

OTHER

Do you have any health problems (Allergies, physical disability, or other limitations) that would be affected by volunteering at LPR (If, YES, Please Explain)

Do you have any experience working with animals (If YES, Please explain)

Do you have any pets (If YES, Please list, Name,Breed,Age,Gender)

Are all animals in the household Spay/Neutered

Are all current animals up to date on vacciantions?

I will be doing volunteer work for LPR and understand and agree to the following Volunteer shall abide by the safety rules, regulations, policies, and procedures of LPR

AGREE

DISAGREE

Volunteers shall work at LPR at their own risk.

AGREE

DISAGREE

Volunteers hereby indemnify and hold harmless LPR for any damages, injury, or casualty resulting from their work on the premises of LPR or in work concerning LPR.

AGREE

DISAGREE

LPR shall not be liable in any manner or form for the negligence or unlawful acts of volunteers

AGREE

DISAGREE

Volunteer Signature

Date

Indicates Response Required