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Dog Rescue Donation Application Form

Animal suffering is a problem around the world and dogs are no exceptions.

If you represent a dog rescue shelter, we would like to touch the life of an orphaned dog and donate to the cause of injured and exploited dogs that usually bring so much joy to our lives.

We believe that this donation will go a long way towards improving the quality of life of at least 1 dog in your shelter.

We are donating a total of $25,000 to be distributed to 500 needy dog rescues.

Please fill in your details and apply for the Donation through the following form:

First Name:
Last Name:
Email Address:
Website Address:
Business Name:
Mailing Address: ( This address is where we will send goods.)
City:
Country:
State:
Zip code:
Day Phone:
Evening Phone:
Please check how you want to receive our donation; Cash Goods, If Cash Paypal Address:
What breed(s) of dogs do you rescue? How do you evaluate your clients before giving away your dogs?
Are you associated with any local, state or national club? Yes No, If yes, What is the name of the club?
We will only select 10 Rescue sites to receive this donation from us. Why do you think your rescue deserves to be one?
Questions / Comments / Suggestions:
Please type the code shown:
I understand that this offer is valid for the next 15 days only and is on a first come, first served basis.

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