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Volunteer/ Foster Application
YOU AND YOUR FAMILY
First Name:
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Last Name:
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Birthdate (MM/DD/YYYY):
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Address:
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City:
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State:
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Zip:
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Home Phone Number:
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Cell Phone Number:
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Which phone number do you prefer we call?
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Home
Cell
Other
Other
Email Address:
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Employer/Occupation:
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Spouse / Significant others first and last name:
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Spouse / Significant other birthdate (MM/DD/YYYY):
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Spouse / Significant other phone number:
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Spouse / Significant other employer:
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Please list all members of your household, their ages and relationship to you (including children):
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Are your children (if you have any) used to being around dogs?
Yes
No
What breeds of dogs have your children (if you have any) been exposed to?
If no children live in the home, will any visit on a regular basis? If yes, please provide ages of children visiting and frequency.
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No
Yes
Yes
Does anyone in your household have pet allergies?
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No
Yes
Yes
Have you or anyone in your household been found guilty of a crime:
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Yes
No
If yes, please explain who and what the circumstances were:
Have you, or anyone in your immediate family, ever been convicted on a charge of, or relating to, animal cruelty?
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Yes
No
Is there any such charge pending against yourself or anyone in your immediate family?
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Yes
No
VOLUNTEERING INTERESTS/HISTORY:
What are your expectations from us as an organization as a potential volunteer?
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What are your interests in volunteering with us? Please mark only the items that you can commit to. You may select as many choices as necessary.
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Fundraising
Fostering (please specify below)
Transporting
Home Visits
Phone calls / Application screenings
Clerical assitance (Thank you notes, etc.)
Helping at events in the community
Other
Other
Have you volunteered with other shelters / rescues in the past? If yes, where?
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No
Yes
Yes
If you have volunteered in the past what did you do as a volunteer? Why did you stop volunteering with the organization?
If you have volunteered in the past what did you do as a volunteer? Why did you stop volunteering with the organization?
If there was a need for a homevisit from a potential adopter, would you be comfortable completing the home visit? If yes, would you be comfortable assessing and sharing with an applicant potential safety issues for dogs of the applicant’s home and yard?
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If there was a need for a transport of an animal, would this be acceptable? If yes, please provide approximate distance and availability:
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ONLY COMPLETE THE NEXT SECTION IF YOU ARE INTERESTED IN FOSTERING: Fostering is a HUGE need for us and we need volunteers we can depend on to step up at a moments notice. Please be as specific as possible so that we are able to contact you when a dog needs assistance.
What breeds of dogs are you interested or available to foster?
Do you prefer a specific age or sex to foster?
Do you or have you owned dogs in the past?
Yes
No
Currently do
Have you ever raised a dog from a puppy to an adult?
Yes
No
Please choose the best description of your home:
House
Condo/Apartment
Townhome
Duplex
Other
Other
Do you rent or own your home?
Rent
Own
If you rent, do you have your landlords permission to dogs in the home?
Yes
No
Please provide your landlords name, address and phone number if you rent if you own please type N/A:
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If you have lived in your home for less than 2 years please supply the previous address for you and your spouse / significant other:
Have you or your spouse / significant other lived in states other than PA? If so please list who has lived in what states:
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No
Yes
Yes
Do you have a fence at your current home? If yes, please describe the type of fence with respect to height, type and location. If no, please explain how you intend to properly exercise your foster dog:
Is anyone home during the day?
No
Yes
Please describe the hours during the day that your foster dog would be alone:
Where do you intend to keep your foster dog when you are not home, at night and when you are home?
If you are interested in fostering, do you plan on using the crate training method for your new foster dog? Please provide specifics in the box below with your thoughts on crate training and how you would use it if you did:
Does your new foster dog need to be housebroken prior to coming to you?
Yes
No
Are you familiar with obedience training?
Yes
No
If yes, what type of obedience training? What are your strengths?
What are some of the behaviors that you expect the dog to experience and how would you handle them?
What behaviors do you feel you would not be able to deal with while fostering?
Are you familiar with the transitional period that dogs may experience when removed from their current home or a shelter and begin settling into a new home?
Yes
No
Do you have any limitations on how long you can keep a foster dog? If yes, please specify.
No
Yes
Yes
We tend to take in dogs with special needs as much as we can. Please select which of the following special cases you would be willing to take into your home:
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Blind
Deaf
Amputated Limb
Senior
Not good with other dogs
Not good with kids
Not good with cats
Not housebroken
Physical Handicapp
REFERENCES
Please list all current pets and their respective information including: Species (dog, cat, etc.), Name and Age:
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Please check which veterinary practices / procedures you currently utilize with your pets:
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Spayed / Neutered
Up to date on vaccines
Microchipped
Yearly well checks
Surgeries / Extra procedures
Heartworm testing
Heartworm preventative
Flea and tick preventative
What heartworm and/or flea preventative do you currently use (if any):
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Please list all previous pets and their respective information including: Species (Dog,cat etc.), Name, Age at Death, Cause of Death.
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Please list your veterinarians contact information below. Be sure to include the name, address and phone number of the practice. If there are multiple vets, please include a time period. **Please contact your veterinarian immediately and allow them to release information to Zoe's House. If you fail to do this, it can lengthen the application process. Thank you!
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Please list two personal references that are not family members. (Please include name, address, phone, relationship to you and years known.)
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Please list a personal reference that IS a family member. (Please include name, address, phone, relationship to you and years known.)
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May a Zoe’s House representative visit your home & family as well as contact the references which you supplied for verification?
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Yes
No
How did you hear about our organization?
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Additional comments / questions:
You are attesting that all information on this form is correct to the best of your knowledge. You also affirm that you are prepared to share your life and home with a dog in need from a few weeks to a few months; a dog that will totally be dependent on you for food, water, shelter, love, affection, and safety.
Upon final approval as a volunteer and upon acceptance into the Rescue Group, I understand:
• I am free to make suggestions that I feel will improve any aspect of the Group’s procedures;
• Final decisions on all Group rescues lie with the Group’s Board of Directors;
• I agree to abide by all procedures and administrative requirements set forth by the rescue;
• I agree that any actions taken by me, as a volunteer, which are contrary to the instructions I am given on any assignments related to the Rescue, make me solely liable for any consequences of said contrary actions; • I agree to hold harmless and indemnify the Board of Directors of Zoe’s House and Zoe’s House, Inc. from any costs or damages incurred by me or a third party as a result of my contrary actions.
By placing your name and date below, you are electronically signing this document.
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Date signing document:
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