AMPS MIN PIN RESCUE DASHBOARD

 

  
 
AMPS Volunteer Application
Date   Click Here to Pick up the date  
First Name  
Last Name  
Street  
City  
State  
Zip Code  
Phone Home  
Phone Work  
Phone Cellular  
Email  
I am applying to:  
Which states can you cover?  
List special skills and areas of interest:  
Do you presently own pets?  
If yes, list the name and kind for each pet (e.g. Waldo — dog; Fluffy — Cat; Petie — Parrot):  
If you own dogs, are they all Spayed/Neutered?  
If your current dogs are not altered, please explain why not  
Are they up to date with Rabies?  
Are they regularly tested for heartworm?  
Are they on monthly heartworm prevention?  
Are there children presently living in your home?  
Kids Ages  
Do you rent or own  
Type Home  
If you rent, do you have permission from your landlord to keep a dog?  
Landlord Name  
Landlord Phone Number  
Fence  
Fence Type  
Fence Height  
Have you ever fostered a dog before?  
How many hours will the dog be alone during the day?  
Where will you keep the dog while you are at work or out on errands  
Do you have a crate to keep the dog in?  
Is there a limit to the length of time you can keep the dog until it gets adopted?  
If yes, how long can you keep the dog?  
Why is there a limit?  
Are you willing to assume financial responsibility for the every day care of the dog?  
Do you understand that all placements must be done through the AMPS application process?  
Do you understand that any min pin you foster as an AMPS volunteer is the sole property of AMPS and must be returned to AMPS if requested to do so?  
Are you willing/able to do home checks and post adoption checks for dogs in your area?  
Are you willing/able to provide telephone support on training and behavioral issues?  
All paperwork for placement in homes (e.g. applications, contracts) must be forwarded to the AMPS Directors within five business days of completion. Are you able to ensure that this requirement is met?  
Would you able to take a dog to a vet for treatment, spay/neuter, Microchipping, etc. (at the expense of AMPS)?  
Would you be able to meet with an interested person at a dog’s location (e.g. owner’s home)?  
Would you be able to have an interested person meet a dog at your home?  
Please provide us with a veterinary reference (including phone number). Note: Due to the new federal laws regarding the privacy act, you will need to contact your vet immediately and give permission for AMPS to contact them regarding your pet’s records.  
Please list a personal reference (Required information is Name, address, phone number, relation to you).  
Any other coments you like to share with us  

 The dog shall reside at the foster family’s address and may not be given to anyone else or placed in any other home or facility. If the dog cannot be kept by the foster family, said family shall notify the Regional Coordinator or Directors of AMPS immediately. The dog may not be sold, abandoned, relinquished to a pound or shelter or another rescue group, transferred or given to any other person, persons, group, organization or institution. By submitting this application, you attest that you have read the above disclaimer and agree to the terms therein. 

You must be at least 21 years old to submit this application.

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