Rescue Partner Application

Rescue Partner Application

Thank you for your interest in becoming a Rescue Partner. We truly cannot do the work we do without our valued partners in the community.
Organization Name:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Contact Name:*

First NameLast Name
Title: *
Primary Phone Number:*
Please enter a valid phone number.
Secondary Phone Number
Please enter a valid phone number.
Email*
example@example.com
Additional Contact Name (if applicable)

First NameLast Name
Additional Contact Phone Number
Please enter a valid phone number.
Additional Contact Email
example@example.com
Preferred Method of Communication*

CallTextEmail
Organization Website URL*
Would you like to be featured on our Rescue Partner Webpage?*

YesNo
Please list all representatives authorized to sign paperwork and transport animals for your organization:*

References

Please provide a list of references including one foster volunteer, a veterinarian, an adopter, and another rescue organization. Please let them know to expect a call.
References (name, phone, email, how long have you known this rescue)*
Representative's Signature

By typing my name below, I certify that I am an officer of this organization and the information I have provided is correct. I promise that I have reviewed the Arizona Humane Society’s Rescue Partner Code of Conduct and agree to be bound to the conditions presented in these guidelines.
Name*

First NameLast Name
Signature*

Clear
Should be Empty:

Questionnaire