Email
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Organization
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Mission Statement
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Website
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Website link to adoptable animals (direct link required, do not put the word "Petfinder" or petfinder.com)
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Facebook page
Guidestar profile link
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Nonprofit tax ID #
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Street Address (not a PO Box)
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Animals Reside In
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If you selected 'Other' please explain. Type NA if you selected another option.
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# of DOGS adopted past 12 months
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# of CATS adopted past 12 months
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# of DOGS currently in foster/facility
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# of CATS currently in foster/facility
Average monthly need for DOG food (lbs)
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Average monthly need for CATS food (lbs)
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Describe food storage capabilities. Include maximum food storage capacity.
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Do you spay/neuter all animals prior to adoption? Yes or No (if no - explain why)
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Describe your adoption program.
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# of employees
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# of active volunteers
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Does your organization have a contract to provide Animal Control Services for any city, county, or municipality? Yes or No (If yes, please explain)
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Have you participated in a "donated" or "low cost" pet food program within the past twelve (12) months? Yes or No (if yes, please explain)
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Please list other food sources.
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Why is your organization requesting support from GBHS?
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Provide your veterinarian's contact information. Note that we will contact your vet for a reference.
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Vet Phone
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By submitting this application, you agree and acknowledge 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) That Rescue Bank 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. Rescue Bank 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 GBHS 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 GBHS or that may be recorded by GBHS 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 GBHS and its pet products donors to use information contained in this application for their internal evaluation and response procedures. (16) All handling fee payments are to be made payable to the Affiliate Organization or GBHS, as requested, and in no event made to any individual or other organization.
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Applicant's position in the organization
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Applicant's phone number
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I have read and agree to the terms and conditions described in this application.
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I have emailed a copy of my IRS Determination Letter to GOODS@gbhs.org. Applications will NOT be considered unless this has been received by GBHS.
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How did you hear about our program? (If you were referred, please list the name of the individual and/or organization.)
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