EmailMe Form - CARE Network Pre-Qualification Form

Name
First Last
Business Name
Email
I am applying on behalf of:
Phone
### - ### - ####
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
I/We can provide the following services:
Foster Home
Transport Services
Professional Boarding
Vaccinations
Spay/neuter
Other veterinary services
Check all that apply
I/We are able to accept the following CARE animals:
Canines
Felines
Small Animals
Equines
Birds
Livestock
Other
Check all that apply
I currently have the following companion animals in my home:
Canines
Felines
Small Animals
Equines
Birds
Other
Check all that apply
For safety purposes, do you have the capacity to keep CARE animals apart (separate kennel, room or other enclosures) from other animals in your home or facility?
Yes
No
I/We can accept CARE animals for up to:
30 days
60 days
90 days
6 months or longer (if needed)
How did you hear about this opportunity?
What experience/background do you have that is relevant for this volunteer position?
By submitting this application you agree to:
Fill out and submit all necessary CARE program Application and Agreement Forms
A site visit from a CARE representative.
Follow all CARE program policies and procedures as outlined in the above CARE forms and as directed by CARE staff for the humane care of animals, confidentiality, and safety.
Provide all necessary food, water, shelter, medications if needed, and other basic supplies for care of foster animals, unless I need supplies provided by APNM.
Never leave a CARE animal outside unattended, nor remove the animal from the home, without specific prior approval from a CARE representative.
Check each box before submitting.