*  Tell Us About Your Rescue
Organization Name       Year Established      
President’s Name    
Physical Address City ST Zip  
Phone Number w/ Area Code    
Website Address     
Are you a shelter  foster care facility other
In a few words, describe your rescue, its mission, and the type of animals you rescue?
 *  Who Will Be Our Contact
Name          Title 
Office Phone         Cell Phone  
Tell Us About Your Marketing
Facebook URL     # of Fans
Size of Email Database      Do you publish a regular newsletter?
If yes, electronic or paper?              Frequency published?
Webmaster Name      Email 
 *  What Is Your Tax Exempt Status   
Less than $5,000 gross receipts in 2011
501(c)(3)    EIN#
      (Please scan-734 and click "Browse" button to select certificate file)
Fiscal sponsorship
Non Tax Exempt
 *  Where Would You Like To Receive Payment?
Payee On The Check    
Mailed To Address City ST Zip   
It is understood that the decision to register any organization and include that organization on the Pics Saving Pets™ website is the sole discretion of the management of Pics Saving Pets™.
Name          Title
Organization          Date  
  * Indicates Required Information

Pics Saving Pets™ | P.O. Box 25669 | OKC, OK 73112 | 800-336-4550 ext 141 | Fax 405-951-7343