Rescue Partner Application

Rescue Partner Application

Thank you for your interest in partnering with Cabot Animal Support Services/Arkansans Assisting Homeless Animals. To expedite your questionnaire, please email a copy of the following to aaha.adoptions@gmail.com after submission: 501(c)3 letter, adoption application & contract, foster home application & contract.
Date*

MonthDayYear
Date
Name of Organization*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Fax Number*

Area CodePhone Number
Email*
example@example.com
Website*
What year was your organization created?*
Are you a 501(c)3? *
If yes, please submit a copy of your 501(c)3paperwork.
Primary Contact*
Title*
Contact Number*

Area CodePhone Number
Contact Email*
example@example.com
What is your preferred method of contact? *
Please list agents that are authorized to pick up animals for your organization below.*
Name, phone, email
What type of animal does your organization accept?*

DogCatOther
If selected "other" above, please list species.*
If you are breed specific, which breed(s) does your organization accept?*
For purebred rescue groups, would you consider rescuing a close mix?*
Your organization will accept (please check all that apply):*

Nursing MothersPuppies/KittensSick/InjuredSeniorsBehaviorally ChallengedHeartworm Positive
Does your organization or anyone affiliated with your organization breed animals?*
Does your organization require every animal to be spayed or neutered? *
If yes, is surgery done before or after adoption? *
If surgery is done after adoption, how do you verify surgery is done and how soon after adoption is surgery required to be completed?*
How do you house rescue animals?*

Foster HomesVeterinarianBoarding/DaycareYour Own FacilityOther
If you use foster homes, how many foster parents are a part of your organization? *
Do you inspect all your foster homes? *
If you use foster homes or your own facility, how many animals do you house on average? *
How do you approve potential foster homes? *
How do you follow up with a foster home once an animal has been placed in his/her care? *
Do you isolate all new animals? *
If yes, how do you isolate them?*
Do you have an area to house sick or injured animals? *
Under what circumstances would you euthanize an animal in your program? *
What is your adoption fee and what services are included in that fee? *
How do you show your adoptable animals to the public (please list all online sites as well as physical sites)? *
If an adopter must return an animal, will you accept the animal back into your program? *
If No, what is the reason?*
Do you follow up with adopters? *
If so, how do you follow up?*
Veterinarian's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
If local, can a representative from AAHA visit your home/facility? *
Please list two references along with phone numbers & email (preferably from shelters from which you have pulled):
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
For AAHA staff only

_____ Approved _____ Declined

Reason declined:
CAS/AAHA Representative Signature: __________________________________

Date: ___________________________________
Should be Empty: