Rescue Application

Name *

First

Last

Organization (MUST be a 501c3 non-profit) *

Your Organization's EIN# *

Applicant's Position in Organization *

Phone Number *

Email *

Website *

Non Profit Tax ID# *

Address (Not a P.O. Box) *

City *

Zip Code *

Animals Reside In *

Facility
Foster Homes
Both

# of dogs adopted past 12 months *

# of cats adopted past 12 months *

Describe food storage capabilities – include maximum food storage capacity *

Are there any other supplies you need that SpoofDawg may be able to help you with? Please list:

Additional volunteer (V2) within your organization authorized for pickup

First

Last

V2 Position in Organization

V2 Phone Number

V2 Email

Additional volunteer (V3) within your organization authorized for pickup

First

Last

V3 Position in Organization

V3 Phone Number

V3 Email

By submitting this application you agree to the following terms and conditions:

1. You are authorized to sign this agreement on behalf of this organization and certify that the information set forth in this application and supporting documentation is correct. 2. You have read and understood the criteria that apply to this application and certify that the group meets each one. 3. The IRS determination letter has not been revoked, canceled or modified. 4. That food shall be protected against dampness, deterioration, and mold or from contamination by insects, birds, rodents or other animals 5. That food spoiled or otherwise contaminated shall not be served. 6. To abide by restrictions or conditions of distribution, if any, imposed by the source of Donation and communicated to Recipient by Donor. 7. Any raw meat provided is not fit for human consumption and shall be used solely for feeding animals. 8. That feeding pet food to ruminant animals is prohibited. 9. To not sell, transfer, trade or barter any Donation or portion thereof in exchange for money, property or services or otherwise allow the items to enter commercial channels. 10. To release both Donor and Donor’s source(s) from any liability arising from the condition of Donation and further agrees to indemnify and hold harmless Donor and its source(s) against any and all damages, losses, claims, causes of action and suits of law or in equity or any obligation whatsoever arising out of or attributed to any action of in connection with Recipients receipt, handling or distribution of Donation. 11. SpoofDawg to the Rescue may list your organization as a participant in its publications, website or other informational materials but will not sell or disclose non-contact information for any commercial purpose. 12. That goods or services are provided on an “as is” and “as available” basis. SpoofDawg to the Rescue expressly disclaims all warranties of any kind, whether express or implied, including, but not limited to the implied warranties of merchantability or fitness for a particular use or purpose. 13. Your organization grants to SpoofDawg to the Rescue the following: 1) the right to include on its website a link to your organization’s website(s), 2) the right to use any image(s) that you submit to SpoofDawg to the Rescue or that may be recorded by SpoofDawg to the Rescue during or in connection with events that involve both organizations. 14. Permit monitoring, including a site visit if requested, by a Donor representative, as reasonable and necessary to verify that compliance with criteria, receipt, handling and use of Donation conform to this Agreement. 15. Applicant grants permission to SpoofDawg to the Rescue and its pet products donors to use information contained in this application for their internal evaluation and response procedures. 16. Any Handling Fee payments are to be made payable to the Affiliate Organization or SpoofDawg to the Rescue, as requested, and in no event made to any individual or other organization.

Signature, must type and OK digital Name *