The Silent Prayer Surrender Form
Welcome to The Silent Prayer Surrender Form!
We are a 501c3 dedicated to giving a voice to the voiceless, and a home to the homeless, for all of our feline friends across long island. This is our surrender form for any owner surrenders or stray surrenders. If you have any questions/concerns regarding the application, please reach out to the following for any assistance: Jasmine (631) 431 - 7762
Now please know, we do require vet records for proof of any vetting that is said to be done. We do require a $100 surrendering fee for adults and single kittens, and $50 surrendering fee per kitten if they're in a litter. This goes directly towards any vetting they need completed that need to be done.
Date
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Month
-
Day
Year
Date
Name
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First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you the legal owner of this pet?
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Yes
No
It is a stray
What veterinarian has currently been seeing this pet? We need the name, number and address of this vet. (N/A if never seen a vet)
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I understand that I will be required to supply all of my pets medical records from the vet in order to surrender to The Silent Prayer rescue.
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Yes
What is the name of this cat(s)/Kitten(s)? If multiple, please list the color nest to their name.
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How old is this cat/kitten?
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Is your pet spayed/neutered?
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Yes
No
Some, not all
Is your cat/kitten snap tested?
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Yes, he/she is negative for both FeLV/FIV
Yes, he/she is negative for FeLV but is positive for FIV
Yes, he/she is positive for FeLV but is negative for FIV
Yes, he/she is positive for both FeLV/FIV
No, my cat/kitten has not been snap tested
Other
What breed is your pet? Please list it nest to your pet's name if multiple.
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What color is your cat/kitten? Please list your pets name next to the color if multiple.
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Please note that most breeders and rescues REQUIRE you to return the pet to them or notify them prior to surrendering your pet. If your pet is from any of the above, please out to them prior to completing this form.
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I understand and have checked with them already
None of the above applies to my pet
Is your cat up to date on vaccines?
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Yes
No
Is your pet microchipped?
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Yes
No
If this was a found stray, has he/she been scanned for a microchip?
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Yes
No
This is my personal pet
How long have you owned/had this pet? Please lists their names next to the time length if multiple pets.
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Does this cat have any known aggressive tendencies, behavioral issues or known bites?
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He/she has behavioral issues
He/she has aggressive tendencies
he/she has known bites
None of the above to my knowledge applies to my pet
If in the case of multiple cats where some have issues and other do not stated in the above, please specify below.
*
What is your pet(s) good with? Please select all that apply.
*
Senior citizens (65+)
Children (0-5)
Children (6-12)
Teenagers (13-17)
Adults
Other cats
Dogs
Other
Is your pet litter box trained?
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Yes
No
Is your pet declawed?
*
Yes
No
Some are, others aren't
Reason of surrender
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Please list the date you need this pet(s) placed by, if a time limit exists.
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Month
-
Day
Year
Date
What is your pet's personality?
*
Please submit a photo for each pet you plan to surrender
*
Browse Files
Drag and drop files here
Choose a file
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Is there anything else we should know about your cat/kitten?
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I understand that I am required to fill out a surrender contract, thus transferring ownership to The Silent Prayer rescue, upon surrender.
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Yes
I understand I am required to pay a surrender fee as stated above in order to surrender to The Silent Prayer. I also understand that if this fee is waived, it will be up to The Silent Prayer, and not the one surrendering. If felt a fee waiver is needed, I understand I must contact the rescue at thesilentprayerrescue@gmail.com and await their response.
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Yes
I understand that filling out this form does not guarantee that my pet will be accepted into The Silent Prayer, and that it will be solely up to The Silent Prayer if they wish to intake this pet.
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Yes
After reviewing and completing this form, is there anything else you'd like to add about your pet, or any questions/concerns in regard to the f or form and surrender process?
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I agree and adhere to the fact that all questions answered above were answered truthfully to the best of my abilities. As well as I agree to all above terms and conditions put in place by The Silent Prayer, as indicated above.
*
Welcome to the end of the surrender form. We hope it was a smooth process for you and didn't take too long. Please look to below for more information.
Please wait to within 24-72 hours to hear back from us, prior to any further contact. We ask you to please give us this leisure time as we are very busy saving lives. If you do not hear back from us after 72 hours, feel free to reach out to us via the contact info listed below. Thank you.
Phone number : (631) 431 - 7762 (Contact , Jasmine)
Email : thesilentprayerrescue@gmail.com
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