First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Home Phone

Cell Phone*

Alt Email

Please provide BIRTHDATES (with name associated with them) for EVERYONE over the age of 18, INCLUDING THE APPLICANT, residing in the home:*

Please provide your complete physical address, including city, state, and zip code*

Home phone:*

Cell phone:*

Please provide your preferred email address*

Please provide your employer, and hours that you work.*

Have you or anyone you reside with been convicted of a crime that includes a Misdemeanor, Gross Misdemeanor, or Felony? *Please note that MNBR does conduct background checks on all applicants as the first step in processing your application. We encourage and respect the privacy of truthful responses. Convictions do not necessarily warrant application denials; however, untruthful responses typically result in immediate application denials.

If yes, please provide more details as this may be grounds for your application being denied.

Was there a specific position or volunteer activity that prompted you to submit this application today?

I understand that as part of my volunteer duties at MNBR, I may become aware of or view information that is considered confidential information. This includes information associated with adopters or surrendering parties. I also understand and agree that I will not disclose or discuss such confidential information with external parties unless permission is given by affected party(ies).*
Choose one: Yes No

Please tell us a little bit about yourself. Also, please describe why you are interested in serving on the MNBR Board of Directors or being involved in our rescue.

Please check any of the following skills that you feel you bring, that will benefit MNBR.
Choose all that apply: Accounting & Finance Animal Behavior & Vet Medicine Community Relations/Public Outreach Development & Donor Relations/Fundraising Event Management Grant Writing Human Resources Marketing Rescue Experience Social Media

What qualifications do you have that would be beneficial to the Board of Directors and the rescue in general?

Please list previous experience in, or with non-profit organizations. What were your major contributions to their mission?

Memberships in other rescue or non-profit organizations: (Please list name of organization, city and state of organization and position held within the organization)

What is your definition of a good board member?

Do you agree that as a Board Member, your actions, either on social media or in person, reflect MNBR and that you will adhere to MNBR Bylaws and our Social Media Policy? *You can find our Social Media Policy Here: https://mnboxerrescue.rescuegroups.org/info/file?file=24381.pdf **You can find our Bylaws here: https://mnboxerrescue.rescuegroups.org/info/file?file=24344.pdf *

Please list any experience you have working with animals:

Board members, Staff members, and other Volunteers tend to be needed to manage the various events MNBR has. We are looking for volunteers to commit to volunteering; would you be willing to help out at events?*

Beginning in 2018; all Board Member positions are two-year terms. The current board elects or appoints members to the board. There is a two-term limit noted in the 2021 MNBR Bylaws; however, a member can change positions or the board can make an exception to extend the term limit if there are not other applicants for that particular position. For more information, please visit this website page: https://mnboxerrescue.rescuegroups.org/info/display?PageID=18433 Did you have any questions on anything referenced?

The next step to this process is reviewing and agreeing to the MNBR Release of Liability and Waiver. RELEASE OF LIABILITY AND WAIVER • I understand that because I may handle and/or come in contact with animals, it is important to discuss being vaccinated against tetanus with my physician. I release Minnesota Boxer Rescue, from all responsibility that may occur because of my not pursuing this matter further, and I understand whatever decision I make is at my own risk. I have read, understand and agree to the above tetanus information. • I acknowledge and understand that as a volunteer of Minnesota Boxer Rescue, I am not covered by workers’ compensation or any other insurance policy through Minnesota Boxer Rescue, for any damages or injuries I may sustain during volunteer activities. I understand that I am responsible for obtaining health insurance coverage through an independent health insurance company. • I fully understand that as a part of my volunteer work for Minnesota Boxer Rescue, I will come into contact with animals either by directly handling them, fostering or through assisting in their care and adoption. Further, I understand that working with animals carries a risk of injury, and that it is possible that I may be bitten, scratched, and/or otherwise injured • I fully understand that as a volunteer and/or foster home for Minnesota Boxer Rescue, my family may come in contact with animals at Minnesota Boxer Rescue events, and I and my family and/or guests may come into contact with animals in my home if I am fostering an animal. I understand that working with animals carries a risk of injury, and it is possible that my family and/or guests may be bitten, scratched and/or otherwise injured. • My typed named is considered my signature to this volunteer liability release and attests to my intent to hold harmless and release from all liability Minnesota Boxer Rescue or any of its past, present or future officers, agents, volunteers, employees or assigns, from all acts, which are related to the normal performance of required and implied duties. • The terms of this waiver shall continue and remain in effect from the signature date and as long as I volunteer or represent Minnesota Boxer Rescue in any capacity. *

I understand and agree to all of the information in the application which includes the Release of Liability and Waiver above. (If no, this application will not be approved.)*
Choose one: Yes No

In case of emergency, I authorize Minnesota Boxer Rescue to notify the contacts listed below.

Primary Emergency Contact: First Name. Last Name, Phone Number(s), and Relationship to Applicant

Additional Emergency Contact: First Name. Last Name, Phone Number(s), and Relationship to Applicant

I understand that if my application is incomplete, Minnesota Boxer rescue will not review it, and it will be denied.*
Choose one: Yes No

Please let us know if you have any additional comments, questions or any additional information you would like to provide.