Long Island Labrador Retriever Rescue, Inc.
- Volunteer Questionnaire -
must be completed and submitted by adult head of household.
Complete, sign and return to LILRR via email, fax or U.S. Post Office
Date:_____________________
Name:__________________________________________________
Age/DOB:_____________________
Street
address:_________________________________________________________________________
Mailing address:________________________________________________________________________
Town/State/Zip_________________________________________________________________________
Home phone:__________________________ Email Address:____________________________________
Preferred Method of Contact (circle): Email Phone
Home Phone Work Phone
Have you thoroughly reviewed the LILRR website and understand our Rescue procedures?_______________
Do you agree
to support and promote LILRR rescue policies and placement
procedures?_________________
Describe your personal experience with the Labrador breed________________________________________
____________________________________________________________________________________
Describe current or past Rescue participation__________________________________________________
____________________________________________________________________________________
Reference/affiliation/phone:_______________________________________________________________
Reference/affiliation/phone:_______________________________________________________________
Occupation:__________________________________________ Work phone:______________________
Please tell us what job you are interested in (Circle one)
- click on hyperlink for more information about particular endeavors -
Foster Home _____
Transport a Labrador to Rescue _____ Perform home assessments
_____
Fundraising _____
Evaluate Labs needing Rescue _____
ID Labs in local shelters_____
Host Public Events_____ Make crafts & fund raising projects _____
Sponsor a Lab:______
Other service:_______________________________________________________________________
Signature:__________________________________ Date:________________________
Complete Following Section If Applying To Volunteer Foster
Have you thoroughly reviewed the LILRR website and understand our Rescue procedures?_______________
Are you aware the rescued Labs remain in their foster home for 8 weeks of assessment and training?_______
Depending on the individual rescued Lab's needs, the foster period may extend greatly beyond the 8 week
minimum. Are you prepared and willing to care for the fostered Lab for an extended period?___________
Are you and your family willing and prepared to release the Lab when assessment determines he is ready for
adoption consideration?____
Do you feel capable of providing honest assessments of the Lab and his
progress?_____________________
Are all household members aware and in agreement to foster a Lab for LILRR? _______________________
What days & hours will you be home to care for and exercise the Lab?_______________________________
Who will care for and exercise the Lab when you are not home? ___________________________________
How often and how long will the Lab be left home alone?_________________________________________
Is your yard completely fenced? ______ Type: ______________________ Height:
____________________
Are you sure
the fenced area is maintained dog
safe?____________________________________________
Where will Lab be kept during the day? _______________________ at night?________________________
Ages of minor children (immediate or regular visitors):
___________________________________________
Do you own or rent your home?_________ How long have you lived at this residence?__________________
Renters: Does your lease permit you to house or add a Labrador size dog?____________________________
Do you have a valid US drivers license?__________ Do you have ready
transportation?_________________
Have you planned a business trip or vacation in the near future?____________________________________
Additional information
___________________________________________________________________
__________________________________________________________________________________
Are you planning to acquire a new dog or other pet in the near future?
____________________
How many pets have you lost or given away in the past ten years?_________________________________
What pets and livestock currently reside on your property? (list below & use additional paper to continue)
Name
Species Age
Sex/neutered? Are you certain your pet will accept a new dog?
1.
__________________________________________________________________________________
2.
__________________________________________________________________________________
3.
__________________________________________________________________________________
4.
__________________________________________________________________________________
Your Vet:_________________________________ Clinic:_______________________________________
Address:
________________________________________________________ Phone:_______________
Are you a professional
or hobbyist in the pet/canine field?______ If yes, in what
capacity?_______________
_____________________________________________________________________________________
What canine clubs and Rescues do you volunteer with are a member of or actively support? ______________
_____________________________________________________________________________________
Signature:__________________________________ Date:________________________
Mail to:
LILRR, Inc.
P. O. Drawer 3011
Shelter Island Hgts., NY 11965
We sincerely thank you for wanting to extend a helping hand to help LILRR endeavors to save the unwanted and orphaned Labrador Retrievers. A volunteer coordinator for your area will contact you after the application has been received and reviewed. Approved applicants must sign an agreement of representation.
phone/fax (exec. coordinator): 631/749-4201
email: lab911@aol.com