Rescue Partner Application

Rescue Partner Application

Please fill out and submit this application along with copies of your adoption application, adoption contract, foster agreement, and non-profit determination letter. This form will automatically be sent to kjones@hswcmd.org. Please email with any further questions.
Name of Organization:*
Director Name:*
Phone Number:*
Email Address:*
Mailing Address:*
Individuals from your rescue who have permission to pull animals:*
Would you like to be added to our rescue plea distributions?*
Are you a 501(c)(3) organization?*
How long has this rescue been established?*
Does your rescue spay/neuter prior to placement?*
Name and phone number of veterinary clinic:*
Where do you house your animals?

Physical ShelterFoster HomesBoarding Facility
If a boarding facility, please list the address and phone number:*
What species of animals do you rescue? (Dogs, cats, farm animals, reptiles, breed/age specific, etc)*
Please list any tests, vaccines, or procedures your rescue requires before accepting an animal into rescue:*
Under what circumstances does your rescue euthanize animals?*
Please provide the contact information for three veterinarians your rescue has worked with in the past two years:
Please list the contact information for any shelters with whom you have worked in the past two years:
If no shelter references, where do you get your animals?*
Local animal control jurisdiction and phone number:*
Please upload your rescue's adoption contract:*

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Please upload a copy of your rescue's 501(c)(3) determination letter (if applicable):

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I,blanks , acknowledge that if approved as a rescue partner, I will be asked to sign a partnership agreement that defines the expectations and promises of both the organization I represent and the HSWC.
Signature*

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