Name:
Your Age:
Address:
City, State, Zip
Home Phone:
Email:
The best time to reach me is:
The best method to reach me is: Phone  Email
I am interested in the following areas:  (Check all that applies) Foster Care
  Events and Activities
  Fundraising
  Home Visits
  Reference Calling
  Transport
  Foster Support (includes such things as vet visit transport, short term fostering, etc.) You need to be available during the day.
  Website
  Computer
  Grant Writer
  Graphic Design
  Photography
  Printing

I would like to volunteer with Shih Tzu Rescue of Minnesota because:

I have talents and education that would be useful in the following areas:

Please share any other information with us that would help us to know you as a volunteer.

 

If you would like to volunteer for Foster Care, please fill out the following:

Please note that fostering a dog is a commitment that will require extra time from you....sticking with the dog until he/she is adopted. It will also cost you some money (food, grooming, leash/harness), and require patience and diligence in the dog’s vetting, rehabilitation & training. Before you say “yes” to taking a foster dog, please consider these things. You are never obligated to take a dog if you feel you can not follow through with him/her.
Type of Dwelling: If other, describe:
  If you live in a rental unit, we will need a letter from your landlord granting authority to foster a rescued dog on the property.
Do you have a fenced yard?
Please describe your fence (type, height):
Do you have a space in your home to quarantine a foster dog if necessary?
Are you a smoker?
(Allergies/breathing issues may prevent some of our dogs from being in homes with smokers.)  
Please list the residents in your house (including yourself) and their ages:
Number of hours your foster dog will be left alone during the day:
Where will the dog stay when you are gone:
If you work full-time, if need be, could you come home at lunch or have someone check on the dog for you?

Other pets in your household (species, breed, sex, spayed/neutered, and age)

Species: Breed: Sex: Spayed/Neutered Age:

Please tell us about the pets you have had in the past and what happened to them:

Please let us know about the types of dogs you would like to foster: Please consider the time factor, exercise factor, and your experience with dogs.  We don't want you to have any "surprises". (Check all that applies)
No Preference  
Dogs with special medical needs  
Dogs with behavioral needs  
Senior Dogs (ages 10 or over)  
Dogs over age 3  
Dogs under age 3  
   
Do you have a gender preference?
How often would you like to foster a dog for rescue during the year? (there is no wrong answer)
Are you familiar with the grooming, dietary and medical needs of a Shih Tzu?
Is there any other information you would like to share with us about your desire to foster, or the type of Shih Tzu you would like to foster?
 

References:

Please provide THREE references, including your Veterinarian if you have one.  Only 1 relative may be used.  Please contact your references to let them know they may be called.

Reference #1 - Veterinarian/Clinic:  
Name:
Address:
Phone:
Best time to call:
   
Reference #2 - Groomer:  
Name:
Address:
Phone:
Best time to call:
   
Reference #3  
Name
Address:
Phone:
How does this reference know you?
Best time to call:
   
Reference #4  
Name:
Address:
Phone:
How does this reference know you?
Best time to call:
   
 

Shih Tzu Rescue of Minnesota Confidentiality Agreement

The volunteer acknowledges that he/she may gain access to Shih Tzu Rescue of Minnesota’s confidential and proprietary information, including, without limitation, mailing lists, personal information related to home addresses and telephone numbers of other volunteers and supporters of Shih Tzu Rescue of Minnesota, information regarding Shih Tzu Rescue of Minnesota’s relationship with shelters, and its policies and procedures.  By agreeing to be a volunteer for Shih Tzu Rescue of Minnesota, the volunteer agrees that he/she will not at any time disclose confidential information to any person or entity who is not an active Shih Tzu Rescue of Minnesota volunteer.  The volunteer agrees that this confidentiality provision shall survive regardless of whether or not the volunteer ceases his/her participation in and support of Shih Tzu Rescue of Minnesota.

has read the above Shih Tzu Rescue of Minnesota Volunteer Guidelines and agrees to comply with them.

Release and Hold Harmless

I fully understand and agree to assume all risks involved in any and all activities, tasks or duties that I perform for Shih Tzu Rescue of Minnesota in my volunteer capacity.  I also understand that the behavior of domestic animals may be unpredictable.  Knowing the risk of handling domestic animals, I agree to assume those risks and to release, discharge and hold harmless Shih Tzu Rescue of Minnesota, its volunteers, agents, officers and directors, and its or their successors, from any and all liability, claims and damages arising out of or as a consequence of, any injury or damages that may result to me or members of my household from any activity connected with volunteer activities for Shih Tzu Rescue of Minnesota. 

I agree to the above terms

(By checking the box above, and by submitting this form to STRMN, this constitutes your electronic signature hereon. STRMN may also require that you submit an original signature via U.S. Mail Service.)