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Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

* GenderMaleFemale

Country

*State/Province

Date of Birth

* Month

* Day

* Year

Surrender Request Form

This form is for surrender requests to Ace’s Place All Dog Rescue. We will look for a fitting foster after receiving your form and will contact you if one is found. We are an entirely foster based rescue and can only assist if we have an open foster home. Please fill out as thoroughly and honestly as possible to find the best fit. We ONLY accept dogs at Ace’s Place All Dog Rescue.

What is your dog’s name?

Name of the dog you are surrendering.

How old is your dog?

What breed or mix is your dog?

How much does your dog weigh?

Why are you surrendering this dog?

Are you the legal owner of this dog?

YesNo

If you are not the legal owner of this dog, what is your relation to the dog?

Are you able to commit to fostering this dog until a home is found? Fosters must commit through the adoption process until a home is found which could be days, weeks, or months and conduct meet and greets/home trials.

This helps us determine if we can intake surrenders, as we are an entirely foster based rescue and rely on having open foster homes to intake dogs. Visit acesplacerescue.org/foster for more information on our foster program.

More About This Dog

Please answer all questions below to the best of your ability, please answer all questions truthfully and honestly.

This dog:

Please select all that apply.

Is crate trainedIs potty trainedKnows a few commandsKnows many commandsWalks well on a leashUnsureNone of the above

This dog is good with:

Small dogsLarge dogsSome dogs (dog selective)No dogs (not dog friendly)CatsKids under 7Older kidsSmall animalsOtherNone of the above

This dog is NOT good with:

You can further explain your answer to this question at the end of the form, please answer to the best of your knowledge.

Small dogsLarge dogsAny dogs (not dog friendly)CatsKids

Personality Traits: Describe your dog!

FriendlyShyHigh energyLow energyCouch PotatoQuietVocalAthleticPlayfulIndependentCurious

Is your dog up to date on the following (please only include vaccines and testing that are ON RECORD)

DAPPv (Distemper/Parvo Vaccine)Rabies VaccineBordetella VaccineMicrochippedSpayed/NeuteredHeartworm Negative on Record (Last 1 Year)None of the aboveUnsure

If your dog has been seen by a vet, are you able to provide us with copies of their records if requested?

If yes, please attach vet records for this dog below.

If you are unable to attach them, or do not have them with you right now, please email records to acesplacerescue@gmail.com

If your dog has been seen by a vet, please include the vet's information below (office name and location):

We may contact this vet for additional records as needed.

What, if any, behavioral issues do we need to be aware of?

What, if any, medical issues do we need to be aware of? Any medications?

Please write or paste a short bio for your dog:

Don't worry about perfection, just help us get to know your dog!

Are you able or willing to make a monetary donation if we are able to accept your dog into our rescue? If so, what amount are you able to contribute? (Optional)

Donations help us cover any needed medical costs, supplies, training, admin expenses, etc. that would be incurred. Not required.

Is there anything else you would like to add?

Upload any good photos to help find a foster. You may also submit any additional photos via email.

Photos are a huge help for us to network your dog with our foster base. If you prefer, you can email photos to acesplacerescue@gmail.com

Please sign that you are the owner or are authorized to rehome this dog:

Signature Please use your mouse or finger (if on phone/tablet) to sign

* Date Signed

* Full Name

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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