Thank you for your willingness to help. Please fill out the following form, so we best know in what areas you are able to help.�� ������������������ 1) What is your name? 2) Please provide your address. (Your information will not be shared beyond your state and local rescuers without your express permission.) 3) Telephone: E-mail: 4) Please tell us about your personal pets: 5) Do you have experience with Rescue, (This IS NOT a requirement): Yes No If so, can you tell us about it? 6) Can you volunteer to: Identify an animal in shelter or pound? Yes No Be a telephone contact for your local shelters and pounds? Yes No Be a telephone contact to assist owners in care and training, or referrals to those who can assist? Yes No 7) Help with transporting Rescues from shelters to foster care, or Veterinarian? Yes No �If yes, distance? Days?��� 8) Foster and care for a Rescued Maltese while it rehabs? Yes Not at this time, but I am interested No If yes, please use FosterCare Form. 9) Be a contact for prospective adopting families? Yes No Help with screening new homes? Perform a Home Visit? Yes No Provide possible contacts for reduced costs with your Veterinarian? Yes No Help with the distribution of materials to your local shelters, and other Rescue groups, to aid in identifying Maltese? Yes No 10) Please provide the name, address, phone, and e-mail (if applicable) of at least one veterinarian reference that is familiar with you: 11) Comments: 12) Would you like e-mail confirmation that your submission was received? Yes please! No, thanks �� �