|
RESPONSIBLE PET OWNERS ALLIANCE
RESCUER APPLICATION
|
INDIVIDUAL: __________________________________________________
GROUP: _____________________________________________________
ADDRESS: ___________________________________________________
CITY/STATE/ZIP: _______________________________________________
PHONE: (_____)_______________________________________________
E-MAIL: ______________________________________________________
WEB SITE: ___________________________________________________
How long in rescue?: _______________
What Breed(s) or Species are you interested in rescuing?
______________________________________________________________
What experience do you have with this breed/species?
______________________________________________________________
______________________________________________________________
______________________________________________________________
Have you worked with any shelters previously? ___Yes ___No
If Yes, please list and attach Shelter Referral(s).
______________________________________________________________
______________________________________________________________
______________________________________________________________
What are your adoption procedures at the present time?
______________________________________________________________
______________________________________________________________
______________________________________________________________
Please describe arrangements for housing and caring for rescued animals:
______________________________________________________________
______________________________________________________________
______________________________________________________________
Do you take back adopted animals? ___ Yes
__ No Explain: ______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
I agree to a home visit (by appointment only) from a representative of RPOA.
I agree to indemnify and hold harmless Responsible Pet Owners Alliance, Inc. and the individual rescue agent and/or group from any claims arising while participating in this program.
__________________________________
Signature
__________________________________
Date
Required Attachments:
Code of Ethics (signed and dated), Veterinarian Referral,
Shelter Referral (if applicable)
Return to: RPOA, 900 NE Loop 410 #311-D, San Antonio, TX 78209.
Fax: (210) 822-9038
|
|
|
