Rescue Application

Vet Reference - Vet & Clinic Name

Clinic Phone Number

How Long Have You Been Affiliated w/ Rescue? *

Is Your Rescue a 501c3? *

Yes

No

Currently in the process of obtaining

Contact Name *

Have you worked w/ another rescue, other than the rescue you are w/ now? If yes, please list. *

If for ANY reason the adoptive home doesn't want to keep the pet they adopted from your rescue, is it mandatory that the pet be returned to you? *

Vet Reference - Vet & Clinic Name *

Specific Breeds You Are Interested In *

By typing my name here, I affirm the above information is correct to the best of my knowledge: *

Rescue Website *

After you have offered rescue, if the dog/puppy gets adopted through our shelter before transport, to a "good" home, is that OK? *

Yes

No

Best Phone Number to Reach You *

Please list the requirements of your foster homes. How many animals are they allowed? Do you do home visits w/ foster homes before they are approved? Please be specific. *

Please attach a copy of your 501c3

Email *

Are your rescued animals spay/neutered before going to the adoptive home? *

Facebook Page

Rescue Name *

Rescue Address ***DO NOT USE P.O. BOX (as most states do NOT accept those on health certificates) *

If no, please explain:

City, State, Zip Code *

Clinic Phone Number *

270-230-8839

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