First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

If you are married, living with someone or have a roommate, please provide their name and contact information. Please, enter N/A if you are single.*

Best time to call*

How did you hear about Virginia German Shepherd Rescue?

Special Talents/Hobbies/Skills:

Have you owned in the last 3 years or currently own a German Shepherd or any other breed of dog?

Please describe your experience with German Shepherd Dogs or any other pertinent dog experience:

Will you give your VGSR dog Heartworm Preventative?

Have you dealt with behavioral issues* with other pets? *Housebreaking, chewing, separation anxiety, etc.

How will you encourage/reinforce appropriate behavior?*

How will you prevent/manage inappropriate behavior?*

Have you ever fostered dog(s) for another rescue?

Please provide the expiration dates of each dog's Rabies and Distemper, and the HW Prevention you use. (Dog's Name; Rabies Expires; Distemper Expires; HW Preventative):*

Please provide the expiration date of each cat's Rabies. If no cats, please enter N/A. (Cat's Name; Rabies Expires;):*

Please, list all veterinarians, including mobile clinics, Name, Address(es) and Phone Number(s), that have provided care for your previous [in the last 3 years] and current pet[s]. By providing this information, you are authorizing a veterinary reference check by a VGSR representative.*

Please list any pets that will be in contact with this dog (Type(breed)/ sex/age for each)*

Is each animal listed above spayed or neutered?

If your animal is not spayed/neutered, please explain why.

Do your pets get along with visiting animals?

Do you have children that will be in contact with this dog?

Ages:

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do your covenants / regulations have any restrictions against large breeds and/or GSDs?

Do you own or rent your home

Landlord’s Name & Phone #:

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What type of fence*
Choose one: Privacy Chain Link Invisible Other

If Fence Type is other please indicate type:

What is the height of the fence*

Is your back yard fully fenced?

How much time will the dog spend alone during the day*

Where will the dog be kept when you are at home?*

Where will the dog be kept when you are not home*

Where will the dog sleep*

What traits would make a dog ineligible to be a foster dog at your home? *

Please describe the type of dog you would be most comfortable fostering: *

Please list the name, phone number and relationship of three personal references (NO FAMILY members, please): Include Name, Relationship, Number and Best time to call.*

Please add any comments, suggestions you may have in the following space. Thank you.

Please check all areas of interest below:

Terms of Agreement

1. I will abide by the mission, rules, regulations, policies and programs of Virginia German Shepherd Rescue as long as I am a volunteer.

2. I will remember in all my dealings with the public that I represent VGSR and will act pleasantly and answer questions politely or refer persons to someone who can.

3. I assume all risks of all personal injuries and property damage, including but not limited to being bitten, scratched,or otherwise injured in connection with my volunteer work for VGSR. VGSR is not liable to me for any injuries, damages, liabilities, losses, judgments, costs or expenses whatsoever, which I might suffer or sustain in connection with the performance of my volunteer activities for VGSR, including those caused by VGSR’s negligence (but not by VGSR’s intentional misconduct). I will indemnify, defend and hold VGSR, and its agents, guests and other volunteers, harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever, sustained byany animal or any person, in connection with my performance of volunteer activities for VGSR, or my breach of VGSR’s rules, regulations, policies and programs.

4. I understand and agree that VGSR may refuse volunteer applications for any reason.

5. I understand that working with stray and abandoned animals carries risks. VGSR cannot predict the temperament of any dog and cannot guarantee you that the dog may not become aggressive. Therefore, I understand that I am

assuming certain risks if I agree to work directly with the dogs. I have acknowledged these potential risks before deciding in which volunteer activities in which I would like to participate.

6. I have accurately completed this volunteer application and have read the above warning and appreciate the risks involved in working with the dogs.

7. I hereby certify that I have never been convicted of animal cruelty, neglect, or abandonment.

I understand that VGSR cannot be responsible for the actions, behavior and/or medical condition of all of the dogs which it seeks to rescue and I agree to assume the risks implicit in working with dogs who may have been abandoned, beaten or otherwise mistreated or abused, or who may suffer from an illness, condition or disease.

8. Conflict of interest: Any person who has a direct or indirect financial interest with VGSR must disclose said interest.

I have read the 'Areas of Operation' policy and by clicking submit acknowledge I am within said areas.

(Submitting this application provides a signature):