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February 22, 2013

Pets of Valor Nomination Form

  • Nominate a brave shelter or rescue pet today! The HSUS

Do you know a rescued or adopted dog or cat who has acted heroically to help a person in need? Nominate him or her for the Pets of Valor Award by completing the form below as soon as possible.

The deadline for nominations is April 11, 2014, at 11:59 p.m. E.S.T.

Please complete a separate nomination form for each animal you would like to nominate, unless two or more animals were engaged in the same heroic event. Please do not submit duplicate nominations for the same animal.
 

If you have questions, or if you have difficulty completing the nomination form, please contact us at petsofvalor@humanesociety.org.
 

   
* Required fields  
   

Nominator's Information
*First name
*Last name
*Address Line 1
Address Line 2
*City
*State/Country
*ZIP Code
*Email
*Phone
Alternate Phone Number
*Did you witness this event?  
*Are you the nominated animal's primary caretaker?
If not, please provide the contact information for the individual who is:
Name
Email
Phone
How did you hear about Pets of Valor?
If other, please specify.
   

Nominated Animal's Information
*Pet's Name
*Pet's Estimated Age
 This Animal Is Deceased
*Pet's Gender
*Pet's Species
*Please explain how the animal being nominated was acquired, including the name and address of the agency or organization from which the animal was rescued or adopted, if applicable (400 word limit).
 

The Heroic Act
*Date of Event
(Event must have occurred between April 1, 2013 and March 31, 2014)
Location of Event
*Please describe the event for which you are nominating this animal in your own words (400 word limit). 
*Were any other pets involved?
If so, please provide their name, species, age, and gender.
*Did the event receive any media coverage? This includes any coverage of the heroic act or any award or recognition that may have followed.
If so, please provide a clipping or web link to media coverage of the event.
If the event was not covered by the media, please provide the name, phone number, and email address of at least one (1) individual who has knowledge of the event for verification purposes.
Name
Phone Number
Email
   
*
*
*