Membership Application

VERY IMPORTANT... PLEASE TAKE TIME TO READ & COMPLETE ALL INFORMATION BELOW BEFORE SIGNING!

In order to join or maintain your membership with RPAL in good standing, it is imperative that you and your group comply with RPAL Terms of Membership. Failure to do so could cause you/your group’s immediate suspension or termination of membership.  

 *REQUIRED  

                         ANNUAL REGISTRATION INFORMATION & STATISTICS:                         

Organization Name:*
Date Established?
Check Are you a 501c3?                    
City Shelter?   
County Shelter?  
  
Independent Rescuer?
Federal EIN If Applicable #
Main Address:*
Main City:*
Main State:*
Main Zip:*
Website:
Facebook Page:

CONTACTS:

Director/Chairperson:*
Phone:*
Email:*
Main Contact Person: *
Title:*
Phone Number:*
Email:*
Alternate Contact Person:*
Title:*
Email:*
Phone Number:*

REFERAL: 

 
How did you hear about RPAL?*

**RPAL requires references to become an RPAL Member - Please include the following:

Rescue references from the Animal Welfare Community

  • Rescue Reference 1:
Name:*
Group:*
Phone:*
Email:*
  • Rescue Reference 2:
Name:*
Group:*
Phone:*
Email:*
  • 3. Veterinarian reference:
Name:*
Phone:*
City/State:*

STATISTIC SECTION: Please consider the following, this information is considered RPAL Confidential and will not be shared with anyone without your written consent. We use the information as a collective total to present to potential donors and foundations how many overall groups we support feed, etc.

Does your group utilize fosters in your program? Yes   No   


Does your group maintain a base facility or shelter? Yes   No   
Total Number of Dogs (on average) in your groups care each day*
General Size or Range*
Average number of dogs adopted per month?*
When you purchase food what dry foods do you typically feed?*
When you purchase foods what wet foods do you typically buy?*
Where do you typically purchase your foods?*
Total Number of Cats (on average – domesticated and/or feral) in your groups care each day:*
Number of Domesticated Cats:*
Number of Feral Cats:
Do you TNR? Yes   No   
Do you Spay/Neuter all of your TNR Ferals?
How many cats do you adopt per month approx?*
When you purchase food what dry foods do you typically feed?*
When you purchase foods what wet foods do you typically buy?*
Where do you typically purchase your foods?*
Do you care for other animals, if yes, what kind and how many of each?
Do you spay/neuter prior to adoption?* Yes   No   
Do you do home visits prior to adoption?* Yes   No   
Does your group have a budget for food or rely on donations for food OR do you rely on donations for food OR Both?* Budget    Donations Only   
Both Budget & Donation 
  
Are you affiliated with or do you receive food from other Food Banks, or regular manufacturer food programs?*

Yes   No   

If Yes, list all food banks or programs here:
Have you completely read and do you and your group agree to abide by the RPAL Terms of Membership ?*
 
Yes No


Attach Non-Profit Paperwork As Applicable


In submitting this document you are stating that your organization has read and completely understands and agrees to all  Terms And Conditions Of Membership and that all information you have presented here to be true an accurate.



RPAL Rescue Center:
106 Business Circle
Terrell, TX 75440
  Toll Free 1.888.473.7725
Email: Help@R-PAL.org 
  Mail:
PO Box 279
Emory, TX 75440