• ADOPTION APPLICATION

  • Approximate Age:*

  • * Please note: The age and breed of this animal is APAC'sbest estimate with input from Veterinarians, and Shelter.

  • Personal Information

  • Do you live in a:*

  • If you rent, you must provide the name and phone number of your landlord/rental agency.

  •  -
  • Does anyone in the home have allergies to dogs, cats, or asthma?*
  • Who will support this pet financially?*

  • Pet Care

  • Where will this pet live?*

  • Where will this pet be kept?*
  • Does your house have:*
  • What do you consider a valid reason for giving up a pet? (Mark all that apply)*

  • Pet Ownership & Vet History

  • What is the date of last heartworm prevention given?
     / /
    2 digit month, 2 digit day, 4 digit year
  • Have any pets in your household been diagnosed with infections diseases or conditions?*
    Rows
  • Please list all pets currently living at your address, ALL boxes for each pet must be completed to move forward in the application process. If no pets, use N/A.*
    Rows
  • Please list pets owned in the last 5 years that are no longer with you:
    Rows
  • Why are the pets listed above no longer with you?
    Rows
  •  -

  • If no, please provide the name of the vet that can confirm current vetting:

  •  -
  • When was your last vet visit?*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Release for Veterinary Reference:

  • I,          hereby give permission for any veterinarian providing service to me to release medical information on any/all of my animals to APAC. This release is for follow-up purposes in the case of existing conditions or simply well check for vaccines, spay/neuter status and heartworm prevention status.

  • The animals in APAC’s foster care are not merchandise. They are living beings entrusted to our care. It is our responsibility to find the best possible homes for them and to meet the individual needs of each animal. Therefore, we have the right to approve or deny any adoption as we see fit.

  • APAC Adoption Agreement:

  • I/We are applying to adopt the Dog described in the attached Application from APAC and take responsibility for this animal. 

    This animal is Fully Vetted at this time (Parvo, Distemper, Rabies), is spayed or neutered, and has been Heartworm tested if older than 7mo. All vet records will be provided to me at time of final adoption process.

    This document will also serve as the adoption contract agreement should adoption result from application.

     

  • Should the need arise, I will reach out to APAC to request a return to the rescue.  When returned within two weeks of adoption, there will be no surrender fee.  The return will be based on availability of foster home openings.  

    I/we certify that the above information is true and correct. I/we understand that false information may result in nullifying this adoption. I agree to discuss the dog I am interested in adopting with the foster family and ask questions to help ensure the dog is a good fit for my home. While foster families strive to provide all the information available on the foster dog being adopted, I understand that the dog may behave differently during the adjustment period in my home. I understand animals can be unpredictable in various situations and will not hold APAC or any representatives responsible for injuries or damages caused by the dog I am adopting.

  • Date*
     / /
    2 digit month, 2 digit day, 4 digit year

  • Upon Submission, this application is sent directly to APAC Rescue for review.  Please allow 24 hours for a response. 

    For questions please contact us at (254) 541-1461 or myhappytail@yahoo.com or contact us on Facebook.com/groups/APACTempleTX

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