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

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Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

Country

*State/Province

Surrender Request - Waiting List Entry

Surrender Request - Waiting List Entry Understanding

I understand that by completing and submitting this form I am providing information that Great River Rescue needs in order to determine if, how, and when they can assist, and their receipt of this application does not guarantee they will be able to accept these pets into the shelter.

YesNo

Pet Information

Information about the pet you are considering surrendering.

How many

How many pets are you looking to rehome?

How long

How long have you had this pet or these pets?

Age

How old is your pet?

Under 6 monthsBetween 6 months and 1 year1 - 2 years2 - 5 years5 years or moreUnknown

Relationship to the pet

What is your relationship to the pet?

OwnerNot the owner, but providing care for itNot the owner, but contacting you on their behalf

Pet Name

What is the name of the pet?

Species

What type of animal is your pet?

DogCat

Breed

What breed(s) do you think the animal is/are?

Weight

Please provide an approximate weight of the animal.

Gender

Gender of animal(s).

Spay/Neuter

Is your pet spayed/neutered?

YesNoSome are, some are notUnknown

Up-to-date with vaccinations?

Was this animal vaccinated within the last year?

YesNoUnknown

Is this pet possibly or definitely pregnant?

Is this pet possibly or definitely pregnant, and, if so, how far long and when due?

When did this pet last see a vet and why?

When was the last time this pet saw a vet and why?

Where do you get vet care?

Please provide the name and contact information of the vet who provided care, treatments, and vaccinations for this or these pets.

Health

Please explain any health issues or conditions we need to be aware of. If there are none, please write "None"

Outside

How much time does this animal spend outside? (Other than dogs going outside to potty)

Indoor OnlyGoes out only with meGoes in and out whenever pet wantsIs mostly or entirely outside

Other details (socialization, special needs, etc.)

Any other details you would like to provide about this pet.

Surrender Donation

Great River Rescue is a private, nonprofit organization that depends on community support to continue our mission of saving companion animals. At the time of surrender, if you are able to donate financially towards the care of these pets, we suggest $25 per altered pet, and $50 per unaltered pet (Maximum $250 for a litter). Are you able to donate this? Please know that the ability or inability to donate financially to the cost of care does not influence whether or not Great River Rescue can accept the animal(s) on this Surrender Request.

YesNo

Why

Why are you wanting to surrender this pet? Please provide a detailed description.

Would you keep this pet/these pets if you could?

YesNo

If you would keep this pet/these pets if you could, what would you need in order to do so. Maybe this is something we can assist with.

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.

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