Find a Rescue Form

Full Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
What type of phone line is this?*

HomeCellBusinessOther
Phone Number 2

Area CodePhone Number
What type of phone line is this?

HomeCellBusinessOther
What would be the best time to reach you by phone?
Example: 12am-12pm
Reference Phone Number (Personal or Veterinarian)*

Area CodePhone Number
State*
How did you hear about Educated Rescue Dogs?

GooglePersonal ReferralViral ReferralOther
Please describe your ideal dog.
Please specifiy any breed preference you may have.
Preferred sex of the dog.

MaleFemaleUndecided
Preferred termpermate of the dog.

Calm/MellowExcitableVery activeUndecided
Preferred fur length.

LongShortUndecided
Please describe your preferred fur color or style if any.
Thank you for completing the Find a Rescue form. Educated Rescue Dogs will evaluate your submission and contact you.
Should be Empty:

Thank you for completing the Find a Rescue form. Educated Rescue Dogs will evaluate your submission and contact you.