Rescue Ambassador Application

Please provide the information requested below. If you haven't gathered it already, please have the following information available:

The number of pets your organization rescued and placed in 2007
The number of volunteers involved with your program
The number of rescue events your group attended in 2007
Your 501(c)3 tax identification number
Copies of your organization's adoption application and adoption contract.

Please note: It may take 4 to 6 weeks to process your application. You will not be able to log in as a Rescue Ambassador during that time. You will be notified when your application has been processed and will be assigned a password upon acceptance.



	*	Organization Name
		Web Site:



*	First Name:
*	Last Name:
*	Title within Rescue Organization
*	Email Address:
*	Daytime Phone:	Ext.
	Evening Phone:
	Cell Phone:
*	Best time or way to reach you:



*	Address 1
	Address 2
*	City
*	State	*Zip:



Use same address as above
*	Address 1
	Address 2
*	City
*	State	*Zip:

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