* COUNTY: Alachua Baker Bay Bradford Brevard Broward Calhoun Charlotte Citrus Clay Collier Columbia DeSoto Dixie Duval Escambia Flagler Franklin Gadsden Gilchrist Glades Gulf Hamilton Hardee Hendry Hernando Highlands Hillsborough Holmes Indian River Jackson Jefferson Lafayette Lake Lee Leon Levy Liberty Madison Manatee Marion Martin Miami-Dade Monroe Nassau Okaloosa Okeechobee Orange Osceola Palm Beach Pasco Pinellas Polk Putnam Sumter Seminole St. Lucie Sarasota Suwannee St. Johns Santa Rosa Taylor Union Volusia Wakulla Walton Washington

DO YOU PLAN ON MOVING IN THE NEXT... 3 Months 6 Months 1 Year Over 1 Year Not Moving

IF YOU ARE MOVING, DO YOU PLAN ON MOVING Out of state? In state?

WHAT IS YOUR AGE RANGE? Under 18 18-20 21-25 26-35 36-45 46-55 56-65 66-75 76 or over

FOR STATISTICAL PURPOSES, WHAT ARE THE OCCUPATIONS OF ALL ADULTS IN THE HOUSEHOLD?

ARE YOU OR YOUR SPOUSE IN THE MILITARY? Yes No

IF YOU ANSWERED YES TO BEING IN THE MILITARY, ARE YOU ACTIVE INACTIVE/RETIRED

IF YOU HAVE VOLUNTEERED WITH OTHER RESCUES PLEASE NAME THEM.

HOW DID YOU HEAR ABOUT SIBERIAN HUSKY RESCUE OF FLORIDA?

PAST EXPERIENCE AND TRAINING:

HAVE YOU EVER BEEN BITTEN OR ATTACKED BY A DOG? YES NO

DID THE BITE REQUIRE MEDICAL ATTENTION? YES NO

IF THE BITE REQUIRED MEDICAL ATTENTION, PLEASE EXPLAIN:

ARE YOU COMFORTABLE APPROACHING A DOG YOU DO NOT KNOW? YES NO

DO YOU UNDERSTAND THAT DOGS MAY BE UNPREDICTABLE AND THAT SHRF, INC. CANNOT GUARANTEE THAT A DOG WE ARE ATTEMPTING TO RESCUE WON'T BECOME AGGRESSIVE? YES NO

ARE YOU WILLING TO ASSUME THE RISKS INVOLVED WORKING WITH ANIMALS WHO ARE SOMETIMES FRIGHTENED OR MAY BE IN UNFAMILIAR SURROUNDINGS AND THE POSSIBILITY THAT THE DOG MAY BECOME AGGRESSIVE AND/OR BITE YOU OR A COMPANION?
YES NO

IF YOU HAVE EXPERIENCE/TRAINING IN ANY OF THE FOLLOWING IT MAY BE OF VALUE TO OUR ORGANIZATION AS A VOLUNTEER, EVEN THOUGH WE DO NOT HAVE ANY SUCH SPECIFIC POSITIONS. YES NO

Breeding
Grooming
Kennel Assistant
Animal Rescue
Training
Vet Tech
Pet Store Sales

PLEASE DESCRIBE THE NATURE AND EXTENT OF ABOVE WORK/TRAINING EXPERIENCE:

DO YOU HAVE OTHER EXPERIENCE AND/OR SKILLS THAT YOU FEEL WOULD HELP YOU IN RESCUE:

PLEASE EXPLAIN OR DESCRIBE ANY OTHER INFORMATION WHICH YOU FEEL IS RELEVANT OR IMPORTANT ABOUT YOURSELF:

WHAT TYPE OF SERVICES HAVE YOU PERFORMED IN THE PAST, OR ARE PERFORMING NOW, FOR OTHER VOLUNTEER AGENCIES?

PLEASE LIST DOG CLUBS/RESCUE ORGANIZATION MEMBERSHIPS PAST AND PRESENT:

PLEASE LIST POSITIONS HELD IF OTHER THAN GENERAL MEMBER:

HAVE YOU EVER OWNED A SIBERIAN HUSKY? YES NO

HAVE YOU DONE ANY RESEARCH ON SIBERIAN HUSKIES? (check all that apply below) YES NO

I HAVE READ BOOK(S) ABOUT THE BREED
I HAVE DONE RESEARCH ON THE INTERNET
I HAVE READ THE SHRF HUSKY EDUCATION PAGES
A FAMILY MEMBER OWNS A SIBERIAN HUSKY
A FRIEND OWNS A SIBERIAN HUSKY
I HAVE TALKED TO PEOPLE WHO OWN HUSKIES

HAVE YOU EVER BEEN CONVICTED OF ANIMAL CRUELTY OR HAD A COURT ORDER AGAINST YOU PREVENTING YOU FROM OWNING OR BEING NEAR ANY ANIMALS, EVEN FOR A SHORT PERIOD OF TIME? YES NO

IF YES, PLEASE DESCRIBE:

PLEASE DESCRIBE WHY YOU ARE INTERESTED IN VOLUNTEERING FOR A GROUP DEDICATED TO RESCUING DOGS ,PARTICULARLY THE SIBERIAN HUSKY?

APPROXIMATELY HOW MANY HOURS PER WEEK DO YOU HAVE AVAILABLE FOR VOLUNTEER ACTIVITIES?

please indicate what you would be interested in doing as a volunteer for Siberian Husky Rescue of Florida, Inc. (check all that apply below):

ANIMAL CONTROL LIAISON
SEEK OUT SIBERIAN HUSKIES IN NEED IN YOUR AREA
PERFORM REFERENCE CHECKS AND HOME INSPECTIONS OF POTENTIAL ADOPTERS IN YOUR AREA
IDENTIFYING PUREBRED SIBERIAN HUSKIES IN YOUR AREA
PROVIDE DOG TRANSPORT WHEN POSSIBLE
WEB SITE MAINTENANCE/DESIGN
COMPUTER GRAPHICS/DIGITAL PHOTOGRAPHY
ADMINISTRATIVE/OFFICE WORK
RETURN PHONE CALLS OR E-MAILS
PUBLIC RELATIONS/FUNDRAISING/MARKETING ACTIVITIES
OTHER (Please Describe)

By filling out this Volunteer Application I/we the undersigned are aware that this does not guarantee me/us a volunteer position with Siberian Husky Rescue of Florida, Inc. If I/we are accepted I will remember in all my dealings with the public that I represent SHRF, Inc. and will act pleasantly and answer questions politely or refer persons to someone who can. If I/we are not accepted to be a volunteer I/we will not misrepresent myself/ourselves as a volunteer and collect donations, applications or do any other activity Siberian Husky Rescue of Florida, Inc., as an organization, is involved in or participates in.

Would you you be willing to sign a 'waiver and release of liability' if you are approved to be a volunteer for SHRF?

Do you have, and can you provide proof of, a valid FL driver's license? YES NO

Do you have, and can you provide proof of, valid auto insurance? YES NO

I have accurately completed this questionnaire, have read the above warning, and appreciate the risks in working with rescue dogs. I understand that SHRF, Inc. cannot be responsible for the actions, behaviors and/or medical condition of the dogs that it seeks to rescue and I agree to assume the risks implicit in working with dogs, which may have been abandoned, beaten, otherwise mistreated, or abused, or who may suffer from an illness, condition or disease.

* SIGNATURE OF APPLICANT:

DATE:

SIGNATURE OF CO-APPLICANT:

DATE:

NOTE: Items indicated by * MUST be completed to submit this form. To submit this application please click the submit button below. If the application has been accepted you will be taken to a confirmation screen and you will receive an email with a copy of your submission, otherwise you will see a screen indicating errors in the required data field(s) and you will have to correct them and resubmit the application. If you do not receive a reply from us within 48 hours please call 727-391-8934.