P. O. Box 1107 Brenham, Texas 77834
Tell Us About The Animal You Would Like To Donate To This Rescue
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| Tell Us About The Animal You Would Like To Donate To This Rescue:
What is the name of the animal?___________________________________________________ What kind and breed of animal is it?_______________________________________________ Why are you donating this animal? ________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 1. Tell us the gender M F , and approximate age__________weight_____________ 2. Has this animal been spayed, neutered? Yes No Unknown 3. Is this animal a stray? Yes No 4. Is the animal current on vaccinations? Yes No Heartworm negative? Yes No (please provide any veterinary records) 5. Is the animal micro chipped? Yes No If Yes, microchip information: _____________________________________________________________________________ 6. Is the animal tattooed or branded? Yes No If yes, please describe the tattoo or brand: _____________________________________________________________________________ 7. Is this animal registered anywhere? Yes No If yes, the name of the organization:__________________ registration number:___________ 8. Does this animal have any disabilities or illnesses? Yes No If yes, please describe: _________________________________________________________
If yes, please describe: ________________________________________________________ __________________________________________________________________________ 10. Can you provide a name and phone number for the vet most familiar with this animal? Name:_____________________________phone______________________________ Location:______________________________________________________________ 11.Please describe the color and markings of the animal:________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 12.Please describe the behavior of the animal include its reaction to people, adults and children, other animals:________________________________________________________________ ____________________________________________________________________________ * Attach a blank sheet answering # 1 – 12 for more than one animal Before placing an animal for adoption we must have a picture of the animal and vet records for the animal. Please include those with this contract. If the animal is not vaccinated and spay/neutered, it will be your responsibility to have that done. No unvaccinated animals will be placed for adoption. Please include those records with this contract. If the animal is not already vaccinated, we will send you a rebate of $25 toward the shots when you send us the vet invoice showing current vaccinations dated after this contract has been signed. We will send you a rebate of $50 for dogs and $40 for cats toward the spay/neuter of this animal when you send us the invoice showing that this has been done and is also dated after this contract has been signed. All previous vet care and any additional vet care will not be reimbursed. If the animal is surrendered to Tbar we also require a $50 surrender fee to help pay for the care of the animal. Being of sound mind, I knowingly, willingly and completely give up all my rights, interests and titles pertaining to the animal(s) described in this contract. There are no legal proceedings pending against me as the owner of the animal(s). I am solely responsible for any legal proceedings that may arise from my previous ownership of the above animal(s). I will be solely responsible for any claims or liens that exist on this animal(s). To my knowledge there are none. The animal(s) listed in this contract may be declined by TBAR at any time prior to placement in an approved TBAR foster home. Acceptance of this animal(s) is contingent on proof of a negative heart worm test in the previous 6 months for dogs or negative feline leukemia for cats. . I relinquish all control of said animal(s) and all rights of ownership of this animal(s) if it is removed from it’s current location. If fostering the donated animal(s) I will notify a Tbar representative within 72 hours if I have personally found the animal(s) a new home. I agree to abide by Tbar’s policies and procedures for adoption when placing this animal(s) in it’s new home. I will attend adoption day events that are set up by TBAR to help find the animal a home. I will allow people to meet the animal and finalize an adoption as requested by TBAR officers. I will collect and send the $75 adoption fee to TBAR in a timely fashion. By accepting this animal(s), TBAR promises to consider what is in the physical and emotional best interest of the animal(s) as we foster and eventually place the animal(s) for adoption. Any changes in this contract must be acknowledged and signed by the donor of the animal(s) and a representative of TBAR. By signing this contract, I acknowledge that I have read it and I agree to the conditions therein and I agree to the adoption policies as set forth by TBAR. As this is an agreement to further the best interests of the animal(s) identified in this contract, I have answered all statements as truthfully as possible to the best of my knowledge. _______________________________ __________________ (Donor signature) (Date) ________________________________ __________________ (TBAR representative signature) (Date) Directory: wp-content -> uploads -> 2013 2013 -> Panels or Round Table Sessions (8) Description 2013 -> Sojourner Truth and the Northampton Association 2013 -> Favorite Books of Wayne Michael Hall 2013 -> Name of School: Department: program 2013 -> Bridging the gulf between sustainability norms and leadership theory Geoffrey Ahern 2013 -> Some interesting readings 2013 -> Guide to inter-agency working to safeguard and promote the welfare of children 2013 -> Dates and theme La Grande Lessive® Download 45.5 Kb. Share with your friends:
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