First and Last Name:
Street Address:
City/State/Zip Code:
Phone:
Alternate Phone:
Email Address:
Have you adopted from Luv A Chin Rescue in the past?
If yes, what dog did you adopt?
Why do you want to volunteer for Luv A Chin Rescue?
Age of Applicant:
Occupation of Applicant:
Occupation(s) of additional adults in your home:
Please list household Members (Name/Age/Relationship to you):
Please list household pets (Name/Age/Breed/Gender/Altered (Spay or Neutered?):
Are your animals all up to date on their vaccinations?
What pets have you previously owned? What breed(s)? When?
How long have you been involved with Japanese Chin?
Have you ever returned, rehomed, surrendered, or given up a dog?
If yes, please explain circumstances of rehoming, surrendering, or giving up a previous pet(s):
I am willing to help Luv A Chin Rescue with (please type all that apply here):
Do you agree to have a representative of Luv A Chin Rescue visit your home by appointment?
What type of home do you live in? For example: House, Apartment, Trailer, Condo, other.
If other type of home, please describe:
Do you own or rent your home?
If you currently rent, are you able to provide HOA/lease documentation stating that you are allowed to have pets?
Are you a member of any other rescue organization?
If yes, please list name of organization(s) and what you do for them:
Do you have any special talents that you would like to share with Luv A Chin Rescue? For example: fundraising, web design, marketing, artistic skills, etc. If yes, please use this space to elaborate:
Please list any dog training/behavioral skills/rescue experience:
How did you hear about Luv A Chin Rescue? Be Specific!
Reference 1
First and Last Name:
Address (City, State, Zip Code):
Phone:
Email:
How do you know this person?
Reference 2
First and Last Name:
Address (City, State, Zip Code):
Phone:
Email:
How do you know this person?
Reference 3 (use this section for landlord contact information, if applicable):
First and Last Name:
Address (City, State, Zip Code):
Phone:
Email:
How do you know this person?
Vet’s Name:
Vet Clinic Name:
Address (City, State, Zip Code):
Phone:
Email:
Have you currently fostered dogs in the past or do you currently foster dogs?
If yes to previously/currently fostering, do you have experience fostering unsocialized dogs or puppy mill dogs?
Which category would you put yourself into regarding length of time you can foster? Please type all that apply here:
What gender do you prefer? Male, Female, No Preference?
Does your vet offer a rescue discount? If yes, how much?
Please check off behaviors you are willing/able to handle: Please type all that apply here:
What age preference do you prefer to foster? Please type all that apply here:
How many hours each day will the foster dog be alone?
If gone more than 6 hours, what are your plans for a mid-day potty break for the dog?
Where will the foster dog be housed when you are not home?
Where will the foster dog sleep at night?
If you travel, where will the foster dog stay while you are traveling?
Do you have a fenced yard?
If yes, please describe your fencing:
Does your fencing completely enclose a yard for a dog?
If no fenced yard, please explain how you will exercise the dog:
If needed, are you able to keep a foster dog separate from resident pets?
If yes, please describe how you will separate the foster dog from your other pets, if needed:
Where will your foster dog will spend most of its time? In the house, yard, basement, garage, other?
If your foster dog will spend the majority of its time in another location, please describe where that will be:
Are you willing to help with transporting dogs at this time?
Do you have a current valid driver’s license?
If you are willing to transport, how far are you willing to travel?
If you are willing to transport, how much notice do you generally need?
Do you have car insurance?
Do you have a working air conditioner in your car?
Do you have a crate or other means to keep a dog restrained in your car?
If yes, please describe how you will keep a dog restrained in your car:
Do you intend to adopt a dog within the next 6 months?
Is there any other information that you feel would help us more fairly evaluate your application?
TERMS AND CONDITIONS OF VOLUNTEERING - PLEASE READ!
I agree that everything I have stated in the above application is true and accurate to the best of my knowledge. I understand that volunteering for Luv A Chin, INC., where I may be asked to pick up, transport, or foster a Japanese Chin or any other breed, carries a certain amount of risk. I accept that risk freely and voluntarily, and I hereby forever release, discharge, and agree to hold harmless the Luv A Chin Rescue, INC., a Nonprofit Corporation, its Board of Directors, officers, agents, and volunteers from all claims, demands, actions, causes of action or liability of any kind whatsoever arising as a result of doing volunteer work for the Luv A Chin Rescue, INC.
By sending/submitting this form, I hereby indicate that I agree to the above terms and conditions of volunteering for Luv A Chin Rescue, INC.
rESCUING, rehabilitating, AND REHOMING jAPANESE cHINS in need!