Name: *
 
Date of Birth (mm/dd/yyyy): *
 
Email: *
 
Contact Phone #: *
 
Home Address: *
 
Primary Area of Interest: *
 
Secondary Area of Interest: *
 
In Case of Emergency Please Notify: *
 
Phone #: *
 
Relationship: *
 
Volunteer search and rescue work is physically demanding! Do you currently have any medical conditions which may limit your ability to participate on search missions? *
 Yes
 No
If you answered "yes" to the above question please explain: *
 
 
 
 
 
Do you have a valid First Aid Card: *
 Yes
 No
Do you have a valid CPR/AED card? *
 Yes
 No
Please list any special skills, trainings, or hobbies that relate to search and rescue: *
 
 
 
Do you have a valid driver's license? *
 Yes
 No
Do you have access to a 4-wheel drive vehicle? *
 Yes
 No
Have you ever been arrested for a felony? *
 Yes
 No
Have you ever been convicted of a felony? *
 Yes
 No
Search Dogs Northwest DOES NOT provide medical, liability, or disability insurances for any member or visitor at group functions. By checking "Yes", I acknowledge that I am responsible for my own safety and any personal insurance I deem necessary. *
 Yes
 No
By clicking "yes" I CERTIFY THAT THE INFORMATION SET FORTH IN THIS MEMBERSHIP APPLICATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. *
 Yes
 No
Applicant Signature (please type): *
 
Date: *