Application to Screen Rescues for YOUR RESCUE OR SHELTER NAME GOES HERE
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Status
New Submission Updated Submission: Our info has changed since approval. We are submitting this so you can update your file.
Today's Date*
Month Day Year
INFORMATION ABOUT YOUR RESCUE
We rescue*
Dogs Cats
We are a (check all that apply)
Foster-based rescue using only foster homes Foster-based rescue which also uses boarding Foster-based rescue which also houses cats in a pet store environment No-kill shelter with controls on intake Open-intake public or county shelter that may euthanize for space or temperament Sanctuary that does adoptions Sanctuary that does not do adoptions
If you are breed-specific, please indicate breed(s) here
Rescue Name:*
Your Name*
Your Title*
Your Website*
Facebook
What other sites do you have? (Check all that apply)*
Petfinder AdoptAPet RescueGroups RescueMe Facebook Twitter Instagram
Mailing Address For Your Rescue (This will appear on the health certificate.)*
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code Country
County in which your rescue is headquartered*
Your local Animal Control Officer/Dog Warden*
Your Home Address (If your rescue address is a PO box, vet may have to use your home address for health certificate.)*
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code Country
Your Email Address*
Retype Email Address*
Your Cell Phone Number*
Area Code Phone Number
Your Rescue's Phone Number (if applicable)
Area Code Phone Number
We request authorized puller information to prevent third-party individuals from falsely pulling animals under your rescue's name. Should your authorized puller contacts change, please notify us by submitting this form again and we will update our files.
Authorized Pullers*
I am the only person authorized to pull animals for this rescue We have more than one authorized puller. I will list their info below.
Authorized Puller 2
First Name Last Name
Authorized Puller 2 Title
Authorized Puller 2 Email
Authorized Puller 2 Cell Phone
Area Code Phone Number
If you have more than 2 authorized pullers, list other people here. Or if you are a very large, multi-state rescue, please explain how we can verify someone who contacts us from your rescue as an authorized puller. For example, is there someone on your board we should contact or cc on emails in response to the inquiry?
Link to your adoption application*
Link to your adoption contract*
Is your rescue a 501(c)(3) non-profit?*
Yes No Application in progress
If you are 501(c)(3), please include the link to the IRS database showing your rescue listed as a non-profit
If your rescue does not have a federal EIN # and it's registered under an individual's social security number instead, please do not list that SS # in the EIN box below. Instead, just put this: SS#/private. We are not interested in receiving anyone's social security number. Please keep that information private.
What is your EIN?*
If you are based in Massachusetts, what quarantine facility do you use?
Does your organization breed?*
Yes No
If you answered yes to the question above, how many litters have you had in the last five years?
What is your kennel license number and whate state is it for?*
If your state or county requires a license, please supply the license number
How long has your rescue been in operation?*
How many animals have you placed in homes?*
How many foster homes do you have?*
Do you board dogs in a kennel in lieu of fostering?*
Yes No
Do you board dogs in a kennel in addition to using foster homes?*
Yes No
If you board, what facility do you use?
Do you always do a home visit on a new foster home before giving them an animal to foster?*
Yes No
Do you always do home visits on adopters prior to adoption?*
Yes No
Current personal animals in your household (all animals not just dogs and cats)*
Current foster animals in your household (all animals not just dogs and cats)*
REFERENCES: Please include your vet and local ACO as well as any shelters you regularly pull animals from.
Reference 1*
First Name Last Name
E-mail*
Cell*
Area Code Phone Number
Reference 1 Type*
Another Rescue Shelter we've pulled from Veterinarian Our Local Dog Warden/Animal Control Officer
Reference 2*
First Name Last Name
E-mail*
Cell*
Area Code Phone Number
Reference 2 Type*
Another Rescue Shelter we've pulled from Veterinarian Our Local Dog Warden/Animal Control Officer
Reference 3*
First Name Last Name
E-mail*
Cell*
Area Code Phone Number
Reference 3 Type
Another Rescue Shelter we've pulled from Veterinarian Our Local Dog Warden/Animal Control Officer
If your rescue has used more than one veterinarian in the last two years, please list additional veterinary contacts here. Any additional references you would like to provide can be listed here as well.
YOUR RESCUE'S PROCESSES AND POLICIES
Are you familiar with parvovirus, how long it can incubate, and how this disease is transmitted?*
Yes No
How long do you quarantine shelter animals after transport before placing them in an adoptive home?*
Do you require animals to be spayed or neutered before adoption?*
Yes No
If no, do you require spaying/neutering after adoption?
Yes No
If spay/neuter is done after adoption, how does your rescue handle this to ensure compliance?
What vaccines are given prior to adoption?*
How often are the animals wormed?*
What is the hold time for new dogs that are received from shelters into your rescue before they are placed up for adoption?*
Do you do home visits for every potential adoption situation?*
Yes No
If you don’t conduct pre-adoption home visits each time, then how often do you do visits?
If you don’t conduct home visits each time, why not?
Has you rescue ever euthanized an animal?*
Yes No
If yes, what were the circumstances?*
Do you always take back the animal if for some reason the adopter can't keep it?*
Yes No
What type of accommodations does your rescue provide for the rescue animals? Check all that apply.*
Foster home Kennel on our property Garage Lives outdoors in fenced yard or dog run No-Kill shelter with physical building Boarded at vet Licensed kennel facility not on our property Cats are kept at Petco or Petsmart in cages Cats are boarded at our vet Cats are free roaming in foster
Do you agree NOT to have unnecessary, cosmetic surgery performed such as ear cropping, tail docking, & declawing?*
Yes No
Do you agree to keep fosters current on vaccinations while in your care & to find a home that will agree?*
Yes No
Do you agree to keep fosters on flea & tick control while in your care & to find a home that will agree?*
Yes No
Do you agree not to euthanize any animal that our shelter has sent you without checking with us first?
Yes No
With the exception of pregnant animals, do you understand that it may be mandatory that the animals you rescue from us be spayed/neutered before going to your rescue? And that you will be required to pay for this surgery?*
Yes No
Do you understand that if any of the information on this application is found to be false, or if we find the animal you are rescuing from us is not being given the proper care (personal or veterinarian), we will reclaim the animal?*
Yes No
What is your standard vetting order for dogs? (check all that apply)*
Rabies vaccine DHLPP vaccine DA2PPV vaccine Fecal test Worm with Drontal Plus Worm with Drontal Worm with Panacur - 3 days Worm with Panacur - 5 days Heartworm Test 4DX Test (may not be available at rural vet) Spay/Neuter Capstar Flea/Tick Preventative If pregnant, do not spay If pregnant, do not vaccinate (if not already done) Health Certificate Ear Check (at vet) Nail Trim (at vet) Bath (at vet) Send me a price quote for all vetting prior to taking dog to vet
What is your standard vetting order for cats? (check all that apply)
Rabies vaccine FIV/FeLV combo test FIV/FeLV combo vaccine Fecal test Deworm with whatever vet recommends Spay/Neuter Flea/Tick preventative Health Certificate
If the shelter requests a site visit, do you agree to allow a volunteer access to your facility/foster home?*
Yes No
TRANSPORT INFORMATION
Where do you typically meet transports? Do you use a paid transport service? If so, please include their contact information.*
Do you have any questions, comments or additional remarks?
Should be Empty:

Application to Screen Rescues for YOUR RESCUE OR SHELTER NAME GOES HERE