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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: ____________________