Petstablished | Manage your Animal Welfare Organization (AWO) with our easy-to-use software.

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

Country

*State/Province

Date of Birth

* Month

* Day

* Year

Disclosures & Certifications

All of our foster homes have other dogs and most have young kids. To ensure their safety, all surrenders must pass our temperament test which includes a dog meet. After receiving the form, we will contact you to schedule the evaluation.

If your dog displays signs of aggression towards dogs or humans, we will NOT be able to place them.

I hereby certify that I am the rightful owner/keeper/caretaker/custodian of the animal(s) who is/are the subject of this Surrender Request form.
(INITIAL BELOW)

I hereby surrender any and all property rights to the animal. I certify that no other person has a right of property to the animal.
(INITIAL BELOW)

I hereby certify that the animal has/has not (select one) bitten a human or another animal within the past 10 days.
(INITIAL BELOW)

I understand that once I relinquish the animal, the animal will not be returned to me.
(INITIAL BELOW)

Type your full name below to acknowledge you have read and understand each of the above disclosures/certifications.

Are the pet's shots current?

YesNoUnsure

Is the pet dog-friendly?

Yes, gets along with all dogsGets along with some dogsNoUnsure

Is the pet kid-friendly?

Yes, children of all agesOlder children onlyNoUnsure

Is there anything else you would like us to know about this pet?

Is Pet #2 dog-friendly?

Yes, gets along with all dogsGets along with some dogsNoUnsure

Is Pet #2 kid-friendly?

Yes, children of all agesOlder children onlyNoUnsure

Is there anything else you would like us to know about Pet #2?

If there are more pets you need to include in this Surrender Request, please include that information below.

Are you able to provide medical records for the pet(s)?

YesNo

Are you able to make a donation towards the pet's care at this time?

YesNo

Photos (recommended)

Please include a photo of the pet(s) you are looking to surrender and their current vaccination records. Photos help us find foster homes faster. If you are unable to attach any at this time, or have more you would like to send, you can email them to grassrootsde@gmail.com.

Select "Choose File" below to upload photos.

I have read and agree to the terms and conditions. By checking this box I am confirming that I am 13 years of age or older. Please note that some organizations have higher age requirements and may require applicants to be 18 or 21 years of age or older. Be sure to review the specific instructions and eligibility requirements for each application carefully before applying.

Surrender Request

Personal Information

Disclosures & Certifications

Details

Photos (recommended)