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BrightHaven Animal Network (BAN) Application

Please read FAQ and Disclaimer below before you complete this form.

General Information

Your Name: (Required)

Your Email: (Required)

Address: (Required)


Animal Information

Name of Animal(s): (Required)

Age: (Required)

Type of Animal: (Required)

City/State Animal Resides: (Required)

State: (Required)

Medication: (Required)

Any known problems: (Required)

If YES, please describe:

Date of Last Vet Visit: (Required)
If blood work or any other diagnostic procedure was done in the last 6 months, a copy must be emailed from the vet to Gail Pope at

Story about the animal and reason giving them up: (Required)

If you have more than one animal, please describe here:

Other Information

Social Media Package includes: Facebook and Twitter post: Fee is $25.00

3 photos of the animal(s) (preferably showing full face): (Required)
Each Photo should be smaller than 5MB with format of .jpg, .png or .gif

I, have the authority to make decisions for this animal. (Required)

I certify that the information provided in this application is true and correct. (Required) If you did not check this box, you will not be able to SEND this form.

To eliminate spam entry, please enter the letters and/or numbers shown below. (Required)


Q: Why does BrightHaven charge for this service?
A: BrightHaven is a nonprofit. General operating costs are substantial in our varied work of sanctuary, hospice, rescue and education. Charging for this service gives us the opportunity to save more animals.
Q: What do your fees cover?
A: Our fees pay for animal care, staff compensation and overhead for daily operations.
Q: What is the BrightHaven Animal Network
A: The BAN is a crucial networking tool that relies heavily on spreading the word of the plight of an animal to our BrightHaven community, followers and friends and to their networks. We will post the animal’s story to our Facebook and Twitter pages.
Q: Does BrightHaven ever make any exceptions?
A: Yes. BrightHaven will review any extenuating circumstances and consider all cases.


BrightHaven cannot accept any liability or responsibility for animals networked via our Facebook and Twitter resources. We network at your own risk and act only as an intermediary.

BrightHaven cannot guarantee that your pet will be fostered or adopted nor can BrightHaven be involved in the decision concerning the placement of the animal and where the animal will be homed. Additionally, BrightHaven cannot guarantee transportation for the animal but will make every effort to assist.