Non-Fostering Volunteer Application

Application for NonFostering Members

First Name:
Last Name:
Email Address:
Date of Birth:
Address:
City:
State:
Zip Code:
Primary Phone:
Secondary Phone:
Current Occupation:
Spouse or Partner Name:
Spouse or Partner Date of Birth:
Spouse or Partner Cell Phone:
Spouse or Partner Occupation:
Please list everyone in your home, listing name, age and relationship to you:
Current and Previous Pets
Please list your current dogs including name, age and breed:
Please provide the name, address and phone number of the vet you use for your dogs:
Current and Previous Volunteer Activity
Are you affiliated with any other rescue organizations?:
If so, please list the organization and the capacity in which you volunteer:
How Can You Help
We are always in need of people to do more beyond fostering a dog. Please check if you are able to do any of the following:
Skills:	Sewing, knitting, or crocheting, jewelry design, card making Providing transport for final placement of a dog or conduct a home visit within a reasonable distance for you Fundraising Help check personal or vet references for adoption
What is your experience/comfort level on the following activities/tools (1=Has experience and connectivity to 5=No experience or connectivity)
Use of computer processes:
Use of social media like Facebook, etc:
Use of fax machine:
Other skills that would help us: ie communication, writing:
How much time can you commit to working for UYR each week?:
References
In addition to the vet reference(s) above, please provide the name, address and phone number of three personal references and your relationship to them. Only one family member who does not reside with you can be used. Examples of references can include groomers, neighbors, coworkers, community member, or anyone who knows you reasonably well. Please let those who you list know that we will be contacting them via phone as part of our reference checking process.
Reference 1:
Reference 2:
Reference 3:
Read the following carefully
I declare that the information I have provided in this volunteer application is complete and correct. I understand that any false information I have provided will invalidate this and any future applications for membership. I understand the first six months of my membership will be probationary and my membership may be dissolved immediately without cause if the Board of Directors deems my intentions or actions to be in conflict with the mission and vision of United Yorkie Rescue. I stipulate that I am applying herein to become a non-fostering volunteer for United Yorkie Rescue and I will maintain automotive, homeowners and health insurance coverage. I will hold United Yorkie Rescue or its representatives, its officers, members, volunteers, associates, or other foster care providers harmless for any liabilities, whether damages are physical, emotional, or property, that are a direct or indirect result of activities I perform as a volunteer for United Yorkie Rescue.
Applicant Signature: