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2. 
4. This is only an application and does not guarantee acceptance
6. APPLICANT INFORMATION
8. Organization Name*
9. President/CEO
11. Organization Address*
13. City*
14. State*
15. Zip Code*
17. Email
18. Phone*
20. Applicant’s Name*
22. Address*
24. City*
25. State*
26. Zip Code*
28. Email*
29. Phone*
31. Is your organization a 501(c)(3)?*

    1. Yes
    2. No
32. EIN#
34. What is your organization’s mission/purpose?
36. Where do you house animals?*

    1. Private Homes
    2. Land/Property
    3. Shelter Facility
    4. Other
37. Explain
39. Species of animals that you rescue:*

    1. Dog
    2. Cat
    3. Other
40. If "Other", what species?
42. Is your organization breed specific?*

    1. Yes
    2. No
43. If 'Yes", list breeds:
45. Do you accept aggressive animals?*

    1. Yes
    2. No
46. Do you accept animals with medical conditions?*

    1. Yes
    2. No
48. Are you able to pick up an animal within 24 hours of being notified it is ready?*

    1. Yes
    2. No
52. ANIMAL CARE INFORMATION
54. Veterinarian Office*
55. Veterinarian*
57. Address*
59. City*
60. State*
61. Zip Code*
63. Email
64. Phone*
68. ACKNOWLEDGEMENTS
70. Please read and agree to the following:*

    I understand that Schertz Animal Services does not release any animal into the care of my organization until it has the opportunity to find a permanent home through adoption. Typically, a minimum of 15 working days from the date of adoption availability. Exceptions may be considered by shelter management for animals that would be difficult to adopt due to age, health concerns, or behavioral concerns.

    1. I understand
72. Please read and agree to the following:*

    I understand that Schertz Animal Services works with each animal to evaluate their temperament. Schertz Animal Services does not guarantee the temperament of any animal, as they do not have any behavioral history on most animals. If aware of any previous aggressive behavior, Schertz Animal Services will provide that information to my organization.

    1. I understand
74. Please read and agree to the following:*

    I understand that all vaccinations, tests, and vet care from the time the animal is released to my organization will be my responsibility, and that Schertz Animal Services will not be held liable for any present or future needs of the animal released into my care.

    1. I understand
76. Please read and agree to the following:*

    I understand that I must provide Schertz Animal Services with the name(s) of the person(s) authorized to pick up an animal on behalf of my organization, each time an animal is transferred to my organization. I understand that I must update this list every time there is a change in personnel.

    1. I understand
78. Electronic Signature of Applicant*
79. Date*
    Date
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81. 1. Receive an email copy of this form.
82. Email address

    This field is not part of the form submission.

83. Submit

* indicates a required field