Great Dane Rescue of Minnesota and Wisconsin
VOLUNTEER application
Please fill out this application fully.
Applicant information
Name: Home Phone: Cell Phone: Work Phone:
( ) ( ) ( )
Address: City: State: Zip Code:
E-mail: Diver’s License Number: DOB: Housing Status: q House q Apartment/Condo q Roommates
Number of Children in Household: Ages of Children:
Complete if Renting
Landlord’s Name: Landlord’s Phone Number:
Landlord’s Address: City: State: Zip Code
REFERENCES
Reference Name: Phone Number:
Reference Name: Phone Number:
Veterinarians Name: Phone Number:
ADDITIONAL INFORMATION IF FOSTERING
Do you have a fenced yard? q Yes q No If yes, what type of fencing and how tall?
Who will care for the dog? How many hours a day will the dog be alone? If travelling, who will care for the dog?
Where will the dog be when left alone? Where will the dog be at night?
Have you ever owned a Great Dane or large breed dog before? q Yes q No ( to foster a minimum of 5 years experience is required) If yes, what breed? Where is the dog now?
List current animals residing in your home
Species Sex Spayed/neutered? Age Time owned
Have you ever bred dogs? q Yes q No If yes, please explain:
Have you ever brought a pet to a shelter or given away/sold a pet? q Yes q No If yes, explain the circumstances:
Are you willing to have a member of GDROMN visit your home prior to acceptance as a foster home? q Yes q No
Are you prepared and willing to spend you own money for the food and incidentals for the foster dog? q Yes q No GDROMN does not reimburse for transport or fostering expenses other than all medical expenses.
Do you have or are you will to take training in canine first aid___temperament evaluation___personal safety___ Please explain
What do you plan on feeding the Dane? q Kibble q Canned q Raw Brand:
Are you aware of the various health problems of Danes such as bloat, DCM, Thyroid, torsion, HOD, Pano, etc? If not are you willing to learn about these issues?
Are you aware of the fact that you will be legally liable for any acts committed by the foster dog and you must carry your own insurance to cover incidents? GDROMN is not liable for any incidents occurring stemming from the behavior of the dog.
Do you have a preference as to the sex of the Dane? (All dogs will be sterilized prior to placement) q Yes q No If yes, what sex is preferred?
Do you have a preference as to the age of the Dane? q Yes q No If yes, what age?
Would you consider a senior Dane? q Yes q No
Would you consider a special needs Dane? q Yes q No
By signing below (or submitting by email) I authorize GDROMN to check the veterinary and personal references listed in this application I certify that the information I have given is true, complete and correct I authorize investigation of all statements in this application I authorize my veterinarian to release all information requested by GDROMN I affirm that I have never been charged with cruelty to animals or any other animal related charges I affirm that I have never been charged with domestic abuse or crimes of violence. Please check all the areas you would like to help with and add any that you would like to do that are not listed. Foster ____ Transport ___ Home Visits ____ Fund Raising ___ Data Entry ___ Search for Danes in need ___ Procure Donated items such as cages, food, toys, laundry soap etc ___ Public Relations ___ Volunteer recruitment ___ Conduct Training sessions ___ Other:__________________________________________________________________________________________________________ I have read and understand the above statements
Signature of Applicant (or submitted by e-mail) Date
OFFICE USE ONLY
Date Received: References Contacted: Veterinarian Contacted: Home Visit Conducted: Background Check: