*(denotes required field)

Date *

Name *

Address *

City, State, Zip *

Home Phone *

Cell Phone *

Work Phone

Email *

Please check all areas below that may interest you.

Meet & Greet *

Home Visit *

Foster Home *

Check here if you are willing to have a home visit *

Coordinate Event(s)

Fundraise

Dog Training

What level of dog training skills do you possess? (Check one)

Beg. Obedience

Advanced Obedience/CGC *

Certified Trainer *

Pet Sitting *

Dog Arrival (bathing / nail trimming etc.)

GUR* (transport)

GEM Store* - The GEM Store needs people willing to travel with the Store along with various other tasks.

Computer Skills

Examples *

Special Skills/crafts *

Examples *

Other (please explain) *

*Your application will be forwarded to the appropriate Program Coordinator