Beach Cities Reptile Rescue

www.BeachCitiesReptileResccue.org

Phone: 949.424.3256

Volunteer Application
Applicant Information
Last Name: Address: City: Home Phone: Email Address: State: Cell Phone: Are you willing to transport reptiles in your vehicle? Yes If yes, please describe: If yes, please describe: First Name: DOB: Apartment #: Zip Code:

Yes No Any Food, Plant or Animal allergies? Yes No Do you have any criminal history? Yes No
Do you have reliable transportation?

No

Prior Reptile Experience

Have you volunteered at any rescue before? Have you had any prior reptile experience?

Yes No Yes No

If so where? If so where?

What type of reptile(s) have you had experience with? Any other reptile experience or education?

Pet Information
Have you had pets in the past or do you currently have pets? Please tell us about them. Name Species Age How are they?

Fostering
Are you interested in fostering a reptile?

Yes

No

If no skip to Emergency Contact Information

What types of reptile are you interested in fostering? Are you currently fostering any animals now?

Yes

No

Do you have experience with the species you are interested in?

Yes

No

Emergency Contact Information

Name: Relationship: Cell Phone: Home Phone:

By signing below, I certify that the information given is true. I understand that Beach Cities Reptile Rescue may deny my application for any reason. I further authorize the investigation of all statements in this application.

Applicant: _____________________________________________

Date: ______________________

To be filled out by a Beach Cities Reptile Rescue member

Date Application Received: Are They Interested in Fostering? Date Application Accepted Reason if Denied : Date Contacted: Age:

Yes

No

Any Experience in Species? Other Information:

Yes

No

Denied :

Member Signature: ___________________________________ Date: ____________________