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Animal Rescue Insurance Application

Animal Rescue Insurance Application


Business Name


Mailing Address


Location Address


Business Contact Information


Buisness Information

Type of Ownership:

Location Information - Where Administrative Work is Done

Construction of Building

Volunteer Information

If so, please complete the Supplemental Pet Store Application portion of the form below.

Evaluation Procedures on Rescued Animals

Where do you get your animals from who are taken into your rescue?

Foster Care Information

Application can only be completed and signed by President, Chairman or Executive Director. When your application is sent we will need 3 Year Loss History from your present insurance carrier or if no prior insurance then resumes must be emailed to us. Resumes must show background experience in the animal care field and what they do for a living. All applications must be fully completed and will need to be resubmitted if not completed. This will delay in in you getting a quote in a timely manner. Before coverage is bound we will need copies of Adoption Contract, Hold Harmless Forms, your Foster Care Application and any Procedure Manuals in place.

Supplemental Application for Organizations Who Use Pet Stores For Off Site Adoptions

Complete the form below if you use Pet Stores as a source for Adoptions.
Construction of Building: