Application Date

MM

DD

YYYY

Name *

First Name

Last Name

Are you at least 18 years old?

Yes

No

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Wireless Phone

(###)

###

####

Do You Own A Pug(s)? *

Yes (I adopted it / them from Bluegrass Pug Rescue)

Yes (I adopted it / them from another Rescue / Animal Organization)

Yes (I purchased it / them from a breeder or pet store)

No

Following Are General Volunteer Categories - Please Indicate Interest Areas.

Arts and Crafts

Cooking / Catering

Event Organizing

Fundraising

Providing Pet Advice

Home Visits / Inspections

Meet and Greet Events

Newsletter Publication

Checking Shelters for Pugs

Transportation (additional application requirements - see below)

Event Setup / Tear-Down

Publicity / Marketing

Social Media (Facebook, Twitter, Instagram, Pinterest)

Raffles (Gift Basket Assembly, Etc.)

Other _____________________________________________________

Do You Have a Valid Driver's License?

Yes

No

Driver's License Expiration Date

MM

DD

YYYY

Valid Vehicle Insurance is Required For All Transportation Volunteers. Do You Have and Agree to Maintain Valid Insurance?

Yes

No

Do You Have a Crate That Could Be Used For Pug Transport If Needed?

Yes

No

For Safety, Bluegrass Pug Rescue Requires That Only Dogs Being Transported, Be In The Vehicle. Do You Agree To This Requirement?

Yes

No

Transported Pugs May Need Temporary Accommodations. Can You Provide This If Necessary?

Yes

No

Are You Available For Short-Notice Transports?

Yes

No

Generally, How Far Would You Be Willing To Transport a Pug?

Locally Only

Up To 25 Miles (One Way)

Up To 50 Miles (One Way)

Up To 100 Miles (One Way)

Up To 150 Miles (One Way)

Anything Necessary

Generally, For What Purpose Can You Provide Transportation?

To The "Forever Home"

Pick Up From Surrendering Homes / Shelters

To / From The Veterinarian

To / From Foster Homes

To / From Special Events

Wherever Needed