EARTH SERVICVES VOLUNTEER APPLICATION

Earth Services

Web site@ www.earthservices.org

P.O. Box 25, Bellevue, MI 49021

269-962-2015

Date : __________________________

Full Name : _________________________________________________________

Spouse name or significant other: ________________________________________

Address: _____________________________________________________________

City __________________________________State_______ Zip ______________

Home phone: __________________________Cell phone ________________________

Employer: _______________________________ Position: ________________________

Home email: _____________________________Work email ______________________

What is the best time to reach you at home? ____________________________________

Are you at least 18 years old? Yes ________ No ___________

How did you hear about us? Website _____ Petfinder ________ Other _________

Volunteer Activities available: Check the areas you would be willing to help with.

_____ Foster care program for dogs/cats: A dog/cats live in your home as a member of your family until adopted. You would be responsible for making sure the dog/cat gets to the vet when needed, to a Pet-A-Thon, and agree to talk to prospective buyers of your dog/cat.

_____Temporary foster care for dogs/cats: Care for dogs/cats in your home when a permanent foster family goes out of town for 1-14 days.

_____Transport: Pick up dogs/cats from a shelter or other driver and take them to designated people or locations.

_____Telephones: Picking up messages from our voice mail system and forwarding them to appropriate volunteers or board members, returning calls for information, or just gathering information about the caller.

_____Home inspections: Visit potential adopter’s/volunteer’s homes, evaluate and fill out interview forms.

_____Calling references: Call references given by potential adopters to verify the animal is going to a good home.

_____Posting flyers: Routinely put up or replace EARTH SERVICES flyers at approved locations in local stores. Help distribute brochures for EARTH SERVICES events to pet stores and pet related locations.

_____Newsletter: Writing and collecting articles and information for our newsletter.

_____Fundraising: Soliciting help, arranging events, sending thank you cards, contacting media, and coordinating volunteers.

_____Working adoptathons: Coming to events for adopting and talking, walking and helping with the animals.

_____Dog/Cat training: Must have experience. Helping our foster dogs/cats become more adoptable and /or taking them to classes.

_____Crafts. Make crafts or solicit people to donate crafts to sell at fundraisers.

If you checked fostering, answering the following:

Are there children in your home? How many ______Ages ___________________

Number of adults in the home ________Do they support fostering? _____________

References (if applying to foster only)

Vet: _______________________________Phone:___________________

Comments (interviewer only) _______________________________________________

Personal: Name ________________________________ Phone____________________

Comments: (Interviewer only) _______________________________________________

Personal: Name __________________________________Phone___________________

Comments (interviewer only) ________________________________________________

If you checked foster care for dogs/ cats or horses…….

We would like to set a date and time to come and visit you in your home. We will bring you a handbook, answer all of your questions, and have you fill out and sign some forms. Please choose three dates/ times that would work for you?

____________________________________________________________________________________________________________________________________________________________

List any innovative idea/talents you may have that you can do for us: _____________________________________________________________________________________________________________________________________________

List the last 5 animals in your home by breed, age, and how long you have owned them:

Breed________________________ Age___ Sex M/ F Years kept? ______

Inside __Outside ___Neutered yes ___ No ___What happened if you no longer have the pet? __________________________________________________

Breed ________________________Age _____ Sex M/F Years kept? ______

Inside__ Outside ___Neutered Yes___ No ___ what happened if you no longer have the pet? __________________________________________________

Breed ________________________Age _____ Sex M/F Years kept? ________

Inside__ Outside ____Neutered Yes__ No __What happened if you longer have the pet? _____________________________________________________

Breed ________________________Age ______Sex M/F Years kept?

_______

Inside __ outside _____Neutered yes ___ No ___What happened if you no longer have the pet? _____________________________________________

Breed ________________________Age ______ Sex M/F Years kept? __________

Inside ___Outside _____Neutered yes ___No ___What happened if you longer have the pet? ________________________________________________________

Are your pet’s vaccinations current? Yes____ No ____ I use Titers Yes ____ No _____

What is your opinion of the following?

Breeding? ________________________________________________________

Neutering/Spaying _________________________________________________

Crate training _____________________________________________________

Obedience training _________________________________________________

Other Rescues:

Have you been or are you a member of another rescue group? Yes ____No _____

Name of organization_________________________________________________

Phone number _______________________________________________________

Reason you left_______________________________________________________

Have you adopted from another rescue group? (Only if you checked fostering) Yes ____ No ____

Name of rescue group _________________________Phone ________________

City_______________________________

Animal adopted_________________________________________

I authorize the investigation of all statements in this application and will sign a printed copy of it upon meeting with EARTH SERVICES volunteer recruiters.

Name________________________________ Interviewer’s initials _____________

Date ________________________