Pomeranian and Small Breed Rescue Volunteer Application Form
Your Name
*
First Name
Last Name
Street Address
*
City
*
within Ontario, Canada ONLY
Postal Code
*
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
-
Area Code
Phone Number
Have you volunteered with Pomeranian and Small Breed Rescue before?
Yes
No
If yes, when and in what capacity?
How did you hear about Pomeranian and Small Breed Rescue?
Please Select
Word of Mouth
Website
Facebook
Twitter
Petfinder
Flyer/Poster
Our Booth at an Event
Other
What activities are you applying for?
Foster Parent
Veterinary Care
Groomer
Home Visit Reviewer
Transport Assistance
Publicity
Please tell us why you are interested in applying for the above position(s)
Please tell us about your experience, skills and qualifications relating to the position(s)
Please tell us about your previous volunteer experience
What did you like best about your previous volunteer experience?
What did you dislike about your previous volunteer experience?
Please tell us about your other interests/hobbies
If you are applying as a Home Visit Reviewer or Transport Assistant please indicate what area you are able to cover
e.g. Downtown Toronto, Niagara Falls, Peel Region, etc.
Have you ever adopted a rescue dog?
Please Select
Yes
No
Current, or most recent, veterinarian and clinic
Veterinarian name
Clinic name
Address
Street Address
Street Address Line 2
City
Province
Postal Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Veterinarian Phone Number
-
Area Code
Phone Number
What name are your pets listed under at the clinic? (e.g. a family member's name, your maiden name)
First Name
Last Name
Personal Reference #1
*
First Name
Last Name
Home Phone Number
-
Area Code
Phone Number
Cell/Alternate Phone Number
-
Area Code
Phone Number
Best time to call
Relationship to Applicant
Personal Reference #2
*
First Name
Last Name
Home Phone Number
-
Area Code
Phone Number
Cell/Alternate Phone Number
-
Area Code
Phone Number
Best time to call
Relationship to Applicant
Please list and describe all of your current pets (name, breed, age, sex, size, how long you have lived with them)
Please list your previous pets and what happened to them
Are your current pets spayed or neutered?
Yes
No
Different spay/neuter status for each pet
If your pets are not spayed or neutered please tell us why not
Are your current pets up to date on vaccinations and prevention programs?
Yes
No
Different vaccination status for each pet
I, the applicant, attest that to the best of my knowledge the above information is accurate and complete and I understand that falsely providing information can mean that my application will be terminated. Sending this application constitutes an electronic signature.
Submit
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