Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number (###) ### #### Email * Animal Information? * Cat Dog Impound # Pet's Name Breed Sex * Color * Age * Housebroken * Yes No Vaccinations * Yes No Surgeries * Yes No Has this pet ever bitten anyone or another animal * Yes No Reason for giving up custody of animal * Other animals still in household and how many I understand the animal I am giving up ownership of becomes the property of Saline Animal League once this form is completed and signed. Owner acknowledges that filling out this form does not guarantee that their animal will be accepted, due to issues of space, animal temperament, etc. * Yes Electronic Signature Thank you!
