Other Type of Pet Submission Form - Guardian Angels for Soldier's Pet

Please read the following items before completing the submission document.

Please provide the following requested information about your beloved animal.
One submission is required per animal that needs a caring and safe home environment due to a deployment (combat or peacekeeping or humanitarian related mission) OR an unforeseen medical and/or homeless hardship.
If submitting more than one Submission Form, please let us know in the Additional Information section (Section 8), if your pets can be placed with different foster home caregivers or if you prefer they remain together. All attempts will be made to keep your pets together in the same foster home when possible, but we cannot guarantee such as it depends on available foster homes in our network at the time a home is needed.
Submissions received with missing information will be returned to the submitter for providing the mission information or the submission does not meet the criteria defined under our Foster Home program details on our website (Programs menus/Foster Home link).
Submission of this document is not a guarantee that we can place your beloved pet.
Pet must be spayed/neutered and current on shots prior to placement into a Guardian Angels for Soldier's Pet© specific registered foster home. This is for protection of your pet, resident pets, pets of others within the same area as the foster home caregiver is located, the selected foster home, and our organization.
ALL fields must be answered even if only N/A is shown to be accepted by the organization.
Print instructions associated with your particular situation. They are provided on our website, which shows other items to be done in addition to submission of this form.

Confidentiality: Any personal information provided to our organization is not shared outside of Guardian Angels for Soldier’s Pet© and only shared with those within the organization that has a need to know. We follow OPSEC (Operations Security) guidelines, any Military and/or VA confidentiality polices, and HIPPA regulations in regards to confidentiality and sharing of information. Your name, email, and telephone number is only shared with a potential foster home caregiver upon your permission to do so. Email will be forwarded to the appropriate state “Foster Coordination Liaison” volunteer who will contact you as quickly as they can to review, answer questions, and begin the process to identify a suitable foster home and place your pet.

SECTION 1: LEGAL PET OWNER CONTACT INFORMATION

his section is for the active duty Military Service Member, wounded warrior, or veteran legal pet owner’s contact information. Reminder: the contact phone numbers and email address must be those of the active duty Military Service Member (MSM) or veteran and may not be those of a spouse, family member, or anybody else. Submissions without the active duty MSM phone numbers or email will be returned for correction. Reminder: the contact phone numbers and email address must be those of the active duty Military Service Member (MSM) or veteran. May not be those of a spouse, family member, or someone else. Submissions without the active duty MSM phone numbers or email will be returned to be corrected.

Rank (active duty only)

Branch of Service (active duty or veteran)

First Name *

Last Name *

Instructions

Street Address *

ZIP Code *

City *

State *

Primary Phone Number *

Secondary Phone Number

Military Email Address (active duty only)

Personal Email Address (active duty or veteran) *

Current Assigned Military Installation (deployment only)

Assigned base and Command for reference purposes should be required for ALL active duty and soon to be retired members

Pet's Current Location

Enter the city and state that the pet is located in.

Foster Home Needed By *

When do you need a Foster Home by (Month, Day, and Year)? This is the latest date that your pet needs to be placed into a specific Foster Home.

Anticipated Foster Term *

Confirm that you have made all efforts for a family member or friend to care for your beloved pet during your deployment or unforeseen in-patient medical or homelessness hardship and have been unable to locate someone able and willing to do so. *

(Initial Box)

Understand and confirm pet must be spayed or neutered prior to placement within a specific foster home through our organization. *

(Initial Box)

Understand you as the legal pet owner are financially responsible for all pet care related costs (such as needed/required veterinary, food/treats, , medications, grooming) for your pet during the foster term. *

(Initial Box) (written decisions have been made between you and the foster home or this is a case involving a Homeless Veteran) Exception: Homeless Veteran and arrangements have been made with the organization’s Natl office.

How did you learn about our Foster Home Program?

SECTION 2: REASON FOR NEEDING A FOSTER HOME

Option 1: Deployment

Combat

Peacekeeping

Humanitarian

Single Service Member

Dual Military deploying around the same time

Married Service Member – immediate family (spouse and/or child) with major medical or handicap situation (explain in comments)

Note: If situation is that an immediate family member has a major medical situation it requires verification of major medical or handicap situation in writing from Primary Care Physician

Option 2: Hardship

Wounded Warrior

Veteran - Inpatient Medical Hardship

Veteran Homeless Hardship – Receiving “hand up” via VA or VA approved Homeless Transition program

Fallen Warrior’s Family Companion Animals

Note: If Veteran Homeless Hardship situation you must provide VA or Primary Care Contact details via Secondary Point of Contact section of this submission.

Explanation of Situation

SECTION 3: AUTHORIZED SECOND POINT OF CONTACT

For Deployments and Fallen Warrior cases, this would be the person who has official authorization to act on your behalf if we are unable to reach you. For Veteran Medical and/or Homeless Veteran cases, this must be the appropriated assigned case worker.

First Name *

Last Name *

Contact Phone *

Email *

Relationship to Pet Owner or appropriate assigned case worker Rep Title *

SECTION 4: CURRENT VETERINARIAN INFORMATION

Business Name

Address

City

State

Business Phone

Website

How often does your dog go to the Vet?

SECTION 5: PET INFORMATION

Reminder: 1 submission per pet if you have more than 1 pet required to be fostered.

Pet's Name *

Other type of pet

Gender *

Age (years - if less than 1 year old, put "1") *

Estimated Weight (lbs) *

Specific Coloring / Markings *

Pet is Spayed (female) or Neutered (male)? Please review “Altered Pet Policy” provided via website. *

Yes

N/A

Is Pet Micro Chipped? *

Yes

N/A

If “Yes” provide, Microchip company name, ID Number, Contact Phone Number and Contact Email.

Is Pet current on Shots based on individual state laws? *

Reminder: copy of most current vaccination record (what shots given, last date given and next date due) prior to pet or pets being placed in any of our registered potential foster homes.

Yes

N/A

Does the Pet have any allergies? *

Yes

N/A

Please list any allergies (including cigarette smoking).

What is your pet’s current living environment (inside or outside pet)? *

Is your pet good with other animals (dogs, cats, other)? *

Yes

Is your pet good with children over the age of 6? *

Yes

Is your pet house-trained? *

Yes

Has your animal bitten or scratched anyone within the last 10 days? *

Yes

What are your animal's favorite games / toys? *

Where does your animal sleep? *

What type of food does your animal eat? (Brand Name / Formula, Canned or Kibble) *

Amount and Frequency of your animal's eating habits? *

SECTION 6: ADDITIONAL INFORMATION

Please provide additional pertinent information pertaining to your particular situation, since the more and detailed information we have, the better we are able to identify a possible good match that meets the need of your beloved pet or pets.

SECTION 7: LEGAL PET OWNER AGREEMENT

I certify that all the information contained in this application is true and correct. *

I agree

I understand that if I have more than 1 pet that I will submit one submission per pet and will submit one picture of each pet submitted. *

I agree

I understand that Guardian Angels for Soldier’s Pet is unable to guarantee that all the pets submitted will be fostered in the same home during the foster term. *

I agree

I understand that circumstances beyond the organization’s control may require us to move the pet or pets to a different foster. *

I agree

I understand I retain full pet ownership responsibilities during the foster term. *

I agree

I understand that I am responsible for all pet care related expenses while pet or pets are in a foster home (cases related to Homeless Veteran situations will be worked out up front with the organization’s Natl office rep). *

I agree

I understand that if the pet submission or submissions are being submitted 14-21 days prior to placement in a specific foster home, the pet owner may need to find temporary care for the pet or pets including boarding. *

Boarding might be required while the assigned FCL is determining the potential availability of an appropriate foster home including boarding such pet, unless different arrangements have been made with our Natl office prior to submitting this form.

I agree

I understand that as the legal pet owner, I will be responsible for reading and preparing the “Fostering Written Agreement” (FWA) jointly with the chosen/approved Foster Home caregiver.

I agree

I understand that if the organization’s assigned “Foster Coordination Liaison” (FCL) is unable to reach me or my authorized legal representative that he/she may contact my command or VA assigned case worker when necessary. *

I agree

I understand it is the responsibility of the assigned FCL to act as the liaison between me and the approved foster home regarding any new issues or questions that may arise during the foster term. *

I agree

I understand that my pet or pets need to be picked up either before or within 5 days after the end of the foster term shown on the prepared/signed FWA. *

I agree

Unless other arrangements have been made within 10 days prior to the end of the FWA designated foster term with the organization’s assigned FCL.

SECTION 8: PET PHOTO

Provide a picture (.jpg file less than 1 Mb) of the pet associated with this submission. *

SECTION 9: SIGNATURE

My full name entered below indicates that I am the active duty military/veteran legal pet owner and declare the information provided for this submission is accurate, complete, and true.

Use the cursor to sign your name.

In addition, I confirm and understand by signing below that: 1) Entering incomplete or false information can result in Guardian Angels for Soldier’s Pet© rejecting this submission or can delay our ability to assist you in a timely manner. 2) If I am submitting more than 1 pet for assistance that Guardian Angels for Soldier’s Pet is unable to guarantee that all the pets submitted will be fostered in the same home during the foster term.

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