New Rescue Application
Rescue Details:
Rescues Name:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Contacts - We keep to 2 contacts to have set communication with
*
Please upload a copy of the rescues 501c3 -
Browse Files
Drag and drop files here
Choose a file
Cancel
of
What is your rescues core values and mission?
*
Has your rescue ever had veterinary care revoked or been denied services at another clinic, animal hospital, or facility? If so, why?
*
Why would you like to be a rescue partner with Paws For A Cause Vet Care?
*
Have you used us in the past? If so, why did the rescue discontinue? If the year passed and you're just reapplying please type - reapplying
*
What specific services and/or support are you looking for with Paws For A Cause Vet Care?
*
How often do you plan to use our services and what volume of cases to you typically handle?
*
What is your typical intake process for animals?
*
Please give reference of any two people whom you feel:
Rows
Full Name
Email
Contact Number
1
2
Please give reference of any 2 Veterinary clinics who your rescue has used:
Rows
Full Name
Email
Contact Number
1
2
All must be agreed upon to move forward in the application;
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name:
First Name
Last Name
Signature
Submit
Should be Empty: