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Volunteer Application

    Select State

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    Pet Information
    Please list all pets owned in the past five years

    Is Pet #1 currently living with you?
    YesNo

    Is Pet #1 been altered?


    Is Pet #2 currently living with you?

    Has Pet #2 been altered?


    Age of Pet #3

    Is Pet #3 currently living with you?

    Has Pet #3 been altered?


    Use the box below for information about any additional pets you've lived with

    Are you over the age of 18?


    Veterinarian Information

    Some vets require you to provide permission before records can be released. Please contact your vet's office and give them permission to provide a reference and release records to 11th Hour Rescue New York.

    Name of Veterinarian

    Street

    Select Vet's State

    Vet's Zip Code

    Please describe your experience with pets and what skill you have to offer as a volunteer?

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