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The Humane Society of the United States 2100 L Street, NW Washington, DC 20037 202-452-1100

Dogs of Valor Nomination Form

The top 15 entries will be named Dogs of Valor Finalists. They will be selected based on the significance and impact of the dogs’ heroic action. From the Finalists, our panel of celebrity judges will select one Grand Prize winner (Valor Dog of the Year) and three Runner’s Up. The top 15 Finalists will also be posted online so you can vote on the recipient of the People’s Hero award.

The call for nominations closes on January 8, 2010 at midnight Eastern Standard Time.

Nomination Criteria

The act for which a dog is being nominated must be a singular heroic event that occurred in 2009.
The nominated dog must have exhibited an extraordinary sense of courage by heroically helping a human in need.
Nominations may be submitted by the dog’s guardian or by any member of the public who has knowledge of the heroic act or occurrence.
Actual events and circumstances surrounding the nomination are subject to independent verification.
A nomination may be posthumous, provided it meets the nomination criteria above.

Nominations must include an original summary (400 words or less) and/or a link to a media account of the event.

If you have questions, please visit our Frequently Asked Questions or Contest Rules.

If you have difficulty completing this form, please send an email to dogsofvalor@humanesociety.org.


*Required
Your Information
*First name
*Last name
*Address Line 1
Address Line 2
*City
*State
*Postal Code
*Email
*Phone
Alternate Phone Number

*Did you witness this event? Yes No
*Do you personally know this dog? Yes No
If so, how?


How did you hear about Dogs of Valor?

If not in list, please specifiy.



Nominated Dog
Dog's Name
Dog's Age
Dog's Gender Female Male
Please upload a photo of the nominated dog.

By checking this appropriate box you agree to grant to The HSUS, its legal representatives, successors, licensees, and assigns, the nonexclusive right and permission to use, modify, adapt, reproduce, publish, and distribute the original nomination story, or any portion thereof, throughout the world, in any printed form and by any kind of mechanical or electronic or any other method or device of reproduction, publication, and distribution known or later developed, during the full term of the copyright, and without notification or payment.

Were any other dogs involved? If so, please give name, age and gender (if possible).



Heroic Act
Date of Event (must have occurred in 2009)
Location of Event
Please describe the event for which you are nominating this dog in your own words (400 word limit).


Please provide a link to media coverage of the event if available. This includes any coverage of the heroic act or any award or recognition that may have followed.


If not covered by the media, you must provide the name and phone number of at least one (1) individual who has knowledge of the event for verification purposes.
Name
Phone Number
Name
Phone Number


Dog's Primary Caretaker
Are you the dog's primary caretaker? Yes No
If you are not the dog's primary caretaker but have contact information for that individual, please provide it below.
Name
City
State
Postal Code
Email
Phone

Yes! I would like to receive action alerts, tips, news, and special offers via email.

Updated May 8, 2009

Dogs of Valor Nomination Form

Nomination Criteria

Your Information

Nominated Dog

Heroic Act

Dog's Primary Caretaker