Turtle Rescue Request - Koi Adoption

First Name *

Last Name *

Email Address *

Confirm Email Address *

Phone Number *

Street Address *

Apartment, suite, etc

City *

State *

ZIP / Postal Code

How can we help you? *0 / 180

A fee of $20 USD is REQUIRED for each turtle/tortoise surrendered to Southern California Koi Rescue regardless of species. This fee is due at time of surrender. Two turtles would require a total fee of $40 USD, etc. * *I understand a fee of $20 USD is REQUIRED for each turtle/tortoise surrendered. This fee is due at time of surrender.

How many turtles would you like to surrender? *

How did you hear about Southern California Koi Rescue? *How did you hear about Southern California Koi Rescue?Search engine (Google, Yahoo!, etc.)Social Media (Facebook, Instragram, etc.)Referral (from a friend or koi pond professional)