Takoda Service Dogs Volunteer Application

Takoda Service Dogs Volunteer Application
Information:
Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number
Email *
example@example.com
Volunteer Interest

Weekend Handler- 2 weekends a month required Fundraising Kennel- 2 shifts a month required Foster Family
Days you are available to volunteer

Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sunday Weekend Home Handler : Friday-Sunday
List Hours you are available. *
- All volunteers must sign a release from Liability and Confidentiality Form. These will be provided after we accept your application.
- Must be 21 yrs or over to volunteer as a Weekend Handler
- 16 yrs or over to work in the kennel area.
- Anyone transporting our dogs must have valid Driver's License and proof of insurance.
- Kennel work includes cleaning of kennels and outside areas, basic grooming of dogs, general cleaning duties such as sweeping, mopping, cleaning of crates, doors, walls, and windows
- We use bleach and other disinfectants for these duties so kennel workers should wear appropriate clothing and footwear for the listed duties and the weather
Do you have any experience working in a Kennel? *
Where have you volunteered in the past? *
Do you know anyone who is or has volunteered with us *
How long do you plan to volunteer with us? *
Reason for volunteering
What are your expectations from this experience?
Do you have any physical limitations? If so please list *
Description of training or experience that may be pertinent to the volunteer position desired.
Statement of and description of prior criminal convictions or offenses
Certifications such as First Aid and CPR with dates of certification and expiration dates.
References: One or more personal references with contact information;
Emergency Contact Information: Include Name, Phone # and relationship to you *
How did you hear about us?
Weekend Home Handler

If you have applied to be a weekend home handler must fill in the questions below. If you did not apply to be a weekend home handler, proceed to the end and submit
Valid driver License State & #
Year, make Model of your vehicle
License Plate # and State
Can you provide proof of registration and insurance?
Do you Own or rent your Home
If you rent, We must have a letter from your landlord agreeing that you can take a dog into your home.
what type of home do you live in?

House Apartment Condo Mobile Home
Do you need to use the elevator to get to your home?
Do you have a fenced Yard?
If yes, type of fence, height
Names and age of all residents in your home
Is anyone in your home afraid of dogs?
Has anyone in your home ever been convicted of a crime
List all Pets you own: breed, name, sex, spayed or Neutered status.
Can you provide Proof of Vaccinations for your Dogs & Cats?
What flea/tick prevention do you use for your pets?
Are you employed?
Name of your employer and contact phone number
Thank you for your interest in our volunteer program. We take the health and safety of our Service Dogs in Training very seriously. We will be in touch with you soon about the status of your application.
Should be Empty:

Takoda Service Dogs Volunteer Application

Information:

Weekend Home Handler