Dixie Dog Express

Todays Date

Name of Sending Rescue

Sending Rescue's Email Address

City of Origin

State of Origin (ex. IL, AK, VT, NH)

City and State of Destination

Number of Dogs

Dog's Name
[NAME]'s Age
[NAME]'s Breed
[NAME]'s Weight
Name of Person Dropping Dog Off
Their Cell # (Including Area Code)
Date of Transport
Name of Person(s) Picking up the Dog(s)
Phone Number of Person(s) Picking up the Dog(s)
Emails of Person(s) Picking up the Dog(s)
At what location is the above listed picking up their dogs:

Enter the code as it is shown:

Agreement

I have read all the requirements that the above dogs listed will need prior to loading on transport

We accept cash, money order, cashiers check or PayPal.
PayPal payments need to be sent to steph2mitch@yahoo.com from your PayPal email address,
choosing the "personal" option on PayPal's "send money" page, and the "payment owed" option.
Please make note of which dog this payment is for!

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