1. Area in which you are interested?:
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2. Are you a Volunteer with another organization?
   Yes
   No
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3. If yes, which one?
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4. Have you adopted from us in the past?
   Yes
   No
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5. If yes, which dog?
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6. Do you have experience with rehabbing unsocialized or puppy mill dogs?
   Yes
   No
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7. Your Full Name:
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8. Email Address:
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9. Phone Number:
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10. Street Address:
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11. City / State / Zip:
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12. Your Profession:
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13. Your Spouse's Profession:
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14. Number of Pet(s) Previously Owned:
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15. Age/breed when acquired?:
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16. Number of Pet(s) Presently Owned:
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17. Tell us about your current pets. Details should include - gender / age / breed / age when acquired, etc:
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18. How's their temperament:
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19. Spayed/Neutered:
    Yes
    No
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20. Do you own or rent?
    Own
    Rent
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21. Your Home:
    Apartment
    House
    Other
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22. Describe your home (state if you have a fenced yard etc):
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23. What percentage of time will your dog be in House / Yard / Other?:
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24. How many hours a day are you away from home?:
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25. Where will your dog be during this time?:
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26. On what occasions do you plan to use a crate, and if so, for how long?
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27. Where will the dog sleep?:
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28. What type of training do you intend for this dog?:
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29. Will you accept a dog that is not housebroken:
    Yes
    No
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30. In many situations, even though the dog may have training, coming to a new home will disrupt that. How do you plan to housetrain this dog?:
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31. Family members (please include their names):
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32. Do you have any experience with rescuing a homeless animal? If yes, explain:
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33. Briefly share your reasons for wanting to Volunteer for Luv-A-Chin Rescue:
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34. Describe your personality:
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35. Hobbies, dog-related or not:
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36. Dog Gender Preference
    Male
    Female
    Doesn't Matter
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37. Age preferred: (we rarely get puppies and seldom dogs under 1 year of age):
    Puppy
    Young Adult 1-3 yrs
    Adult 4-7 yrs
    Senior 7+
    Doesn't Matter
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Please provide THREE references. If you rent, you MUST include your landlord as a fourth reference. For the first three, you may include a neighbor or anyone who owns a high maintenance breed who has knowledge of you with dogs. If you aren't including a landlord, you must include your vetinarian information.

1. Full Name:
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2. Full Address:
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3. Phone number:
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4. E-mail Address (if known):
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1. Full Name:
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2. Full Address:
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3. Phone number:
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4. E-mail Address (if known):
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1. Full Name:
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2. Full Address:
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3. Phone Number:
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4. E-mail Address (if known):
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1. Full Name:
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2. Full Address:
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3. Phone number:
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4. E-mail Address (if known):
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1. Clinic's Name:
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2. Veterinarian's Name:
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3. Full Address:
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4. Phone number:
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5. E-mail Address (if known):
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1. I understand that it is not always possible to determine the exact age of a rescue dog. I am willing to accept a dog that is presumed to be in the age bracket I have specified.
   Yes
   No
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2. I understand that the dog I foster is the possession of Luv-A-Chin Rescue and I agree to follow their guidelines for it's care.
   Yes
   No
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3. Electronic Signature:
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4. Today's Date:
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