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Surrender Application Form

Personal Information

First Name:
Field is required!
Field is required!
Last Name:
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Field is required!
Phone Number:
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Field is required!
Email Address:
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Field is required!
Address
Please include Suburb and Post Code
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Field is required!

Animal Information

Is your animal Microchipped?
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Field is required!
Microchip Number
15 digits - all 15 spaces MUST be filled to move forward
You must enter 15 digits
You must enter all 15 digits
I am the legal owner of this animal. The microchip number listed above is registered to me.
Field is required!
Field is required!

GAR cannot accept animals without written and signed permission from the registered owner. Please contact our intake manager at manager@geelonganimalrescue.org.au with any queries.

By submitting this form I declare that I am the legal owner of this animal.

Animal Name:
Field is required!
Field is required!
Age
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Field is required!
Species:
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Field is required!
Breed:
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Field is required!
Sex:
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Field is required!
Is your animal desexed?
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Field is required!
Is your animal up to date with Vaccinations?
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Field is required!
What is the animals behaviour like with dogs?
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Field is required!
What is the animals behaviour like with cats?
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Field is required!
What is the animal like with children?
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Field is required!
Does the animal have any behavioural issues?
Digging, jumping fences, escaping from yard, jumping, barking, chewing, shyness, aggression, etc.
Field is required!
Field is required!
Please tell us a little bit about the animals personality:
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Field is required!
Please tell us a little bit as to why you are surrendering your pet:
This lets us know what training/vetwork the animal will need once in care, and also help us place them with the most suitable foster carer
Field is required!
Field is required!
If you have any further information you would like to add, please do share:
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Field is required!

Thank you for filling out our Surrender Form

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