First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone*

What would you like to help with?

Other Position:

Are you 19 or over? *
Choose one: Yes No

What experience do you have volunteering? and have you ever volunteered with an animal rescue group?*

How many hours a week are you able to dedicate? *

If you are interested in helping with transport, how many miles can you drive at a time (round trip)? How often and what day(s) of the week work best for you?

For Transport: Please provide the color, make, and model of your vehicle, the license plate number, your drivers license number and expiration date:

Please provide the name and contact information of the veterinarian who currently has your pet’s records. If you’ve recently changed clinics, please also include the most recent that would have their full history.*

Please list the name of the person's account the vetting records are under:

Please list 2 references with names and phone numbers who are familiar with you and your current/former pets’ day to day living. Please do not list significant others, family members, or anyone currently living in your residence. (Note: a couple does not count as 2 references, only 1.) *

What questions can we answer for you?

Volunteer Acknowledgment and Release I understand that volunteering with Great Plains Pointer Rescue, Inc. (GPPR) is my choice and may involve handling dogs with unknown histories or behaviors. I accept full responsibility for my own safety and property while volunteering. I release GPPR, its officers, volunteers, and representatives from any claims for injury, loss, or damage arising from my volunteer activities. I understand GPPR does not automatically reimburse costs I may incur while helping dogs. Reimbursement is considered only if pre-approved by GPPR through adoption donations, local club funds, or fundraising proceeds. I give GPPR permission to contact the references listed in my application. (Please e-sign by entering your name and date.)*