APES Shelter Request Form (Benefit Service User)

Please use one form per animal or bug colony. Please note as the legal owner of the animal we will require you to sign a release form at the time of surrender.

Today's Date *
Animal Details
Animal Name
Age Group
Actual Age
Sex
Species * We do not take in cats or dogs. Please see our cat and dogs rescue page for information on rescues that accept these.
Breed * We do not take in cats or dogs. Please see our cat and dogs rescue page for information on rescues that accept these.
Colour
Image of animal
Features
Markings or distinguishing features *
Name and Address
Title *
First name *
Last name *
Address *
Town *
Postcode *
Email *
Home Tel
Mobile *
	Can we text you on this mobile number?
Although for service users on benefits we do not charge our standard fee. Can you donate any amount? *
We currently require your pet to come with it's housing. Do you acknowledge this? *
Is collection requied? *
Reason for rescue/surrender? *
Comments
Opt-In for updates.

APES Shelter Request Form (Benefit Service User)

Animal Details

Features

Name and Address