First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Text/Pager Email

Applicant Age*

Driver's License #*

Vehicle Year, Make & Model*

License Plate #*

State insured In?*

Name of Car Insurance company?*

Do you have experience w/ Rottweilers?*

Have you ever owned a Rottweiler or any other breed Dog ?

If you own or have owned a dog, is it/was it (check ALL that apply):
Choose all that apply: Spayed or Neutered Current on Vaccines On Heartworm Preventative On Flea/Tick Control

If not, please explain why: *

Veterinarian's Name, Address and Phone Number*

During which hours are you available for volunteer assignments?
Choose all that apply: Weekday Afternoons Weekday Mornings Weekday Evenings Weekend Mornings Weekend Afternoons Weekend Evenings

Why are you interested in working with ARRF?*

Tell us in which areas you are interested in volunteering
Choose all that apply: Transporting Dogs Events Fieldwork Fundraising Deliveries Phone Calls Newsletters Volunteer Coordination Veterinary Visits Planning Dog Walking Dog Sitting Home Checks Brochures/Flyers Letters Grants Projects

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.*

Summarize your previous volunteer experience. Please list other rescues/shelters you have worked with*

Person to Notify in Case of Emergency (Please include Full Name, Street Address, City, State, Zip, and at least two phone numbers including area code.*

At no time will any volunteer bring a dog into the ARRF program without the written permission of at least two (2) committee members, all dogs must be evaluated by one or more committee members. Any dog brought into this rescue without the permission of at least one (1) of the committee members is the sole responsibility of the volunteer as far as legal, medical and liability are concerned.

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Applicant(s) Signature*

Date*

The above statements have been read and understood. The answers supplied herein are truthful and I am ready to make a commitment to volunteer for Atlantic Rottweiler Rescue Foundation, Inc. As a volunteer, I will provide my own automobile and health insurance, and hereby agree to not hold Atlantic Rottweiler Rescue Foundation / A.R.R.F. or any of its volunteers, associates or foster care providers liable for any physical, emotional or property damage that is a direct or indirect result of activities involved in the placement, transport, grooming, training or evaluating of Rottweilers in any way associated with A.R.R.F. This includes any and all activities I perform as an A.R.R.F. volunteer. I have read and fully understand that by signing this wavier and application, I accept full responsibility for myself and/or minor (if legal guardian). ARRF is not responsible or liable. Volunteer Initials: *

ARRF Rep Initials