HWAH- Rescue Partner Qualification Form



General Info

Name of Rescue

Name of Contact person

Phone

Address

 

Email

Website

Date of 501(c)(3)

 

EIN #


History Info

Do you do Home Visits before Placement?

Will you take a dog/cat back if the adopter wants to give it up?

You agree to give regular updates and pictures for the dogs/cats that we help.

Please attach a copy of your adoption contract:

Accepted file types: jpg, gif, png, pdf, Max. file size: 100 MB

Rescue Vet Reference

Rescue Vet's Phone number

Rescue Groomer Reference

Rescue Groomer's Phone number


Previous Adopter References

Please list 2 References below:

1st Adopter Reference Name

 

Adopted Dog/Cat Info

Name Breed

Age

1st Adopter Reference phone #

City/State

 

Email

 

2nd Adopter Reference Name

 

Adopted Dog/Cat Info

Name Breed

Age

2nd Adopter Reference phone #

City/State

 

Email

Leave this empty:

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Signature Certificate
Document name: HWAH- Rescue Partner Qualification Form
lock iconUnique Document ID: cf8d0e0b048ce2414cc845301570b545269ff11a
Timestamp Audit
June 28, 2021 9:12 am EDTHWAH- Rescue Partner Qualification Form Uploaded by Fiscal Sponsorship - fsp@unitedcharitable.org IP 108.28.172.231
September 20, 2021 2:10 pm EDTIsaac Leeth - isaac@unitedcharitable.org added by Fiscal Sponsorship - fsp@unitedcharitable.org as a CC'd Recipient Ip: 108.28.172.231
September 20, 2021 2:10 pm EDTSher Polvinale - hwahsher@gmail.com added by Fiscal Sponsorship - fsp@unitedcharitable.org as a CC'd Recipient Ip: 108.28.172.231