Rescue Adoption Application Form
SHEBAS
Name Of Dog Applying For
*
Please Select
Scrappy
Skeeter
Joe
Scamp
Rascal
Jelly
Roger
Damon
Adam
Hannah
Brat
Lainey
A dog not listed is not available. A * indicates adoption pending.
Applicant Details
Name
*
First Name
Last Name
E-mail
*
Confirmation Email
example@example.com
Age
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (Mobile)
*
Phone Number (Work)
*
Phone Number (Home)
*
Employer Name/Address/Phone:
*
Residence:
*
Single Family Home
Duplex / Twin
Condo / Townhome
Trailer
Apartment
Other
Fenced Yard?
*
Yes
No
Ages of Children in Your Home:
*
Veterinarian Name
*
Provide previous veterinarian if no current vet
Veterinarian Phone
*
Please enter a valid phone number.
Veterinarian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other In Home Pets: NAME/AGE/BREED
*
TERMS AND CONDITIONS
*
I confirm that all information supplied above is correct and accurate.
I understand that this application does not guarantee adoption of any pet from Shebas, and that my application must be approved.
I understand and agree that any pet I am approved to adopt from Shebas will have an adoption fee and that the adoption fee is a tax deductible donation to Shebas, not a sellers fee or buyers payment.
I understand that the adoption fee is non refundable for any reason.
I understand all dogs adopted from Shebas must be spayed or neutered.
I understand that Shebas reserves the right to deny my application for any reason. I understand that, if approved, this application converts into a legally binding and enforceable contract between myself and Shebas.
I agree that Shebas cannot guarantee the health or mentality of any pet, and while every effort is made to determine all pets are mentally sound and free from any health conditions, Shebas cannot be held liable for any damage or injury caused by a pet I adopt, nor for any illness, injury or death the pet suffers after I take possession of the pet. All expenses related to the pet become my sole responsibility once the pet leaves the care of Shebas.
I agree not to rehome, sell, give away, abandon, neglect or in any way abuse or allow to be abused any pet I adopt from Shebas.
I understand that should I become unwilling or unable to continue to care for any pet adopted from Shebas at any point in it's life I will return the pet to Shebas.
I understand that the adoption fee covers in part age appropriate vaccinations and spay or neuter. If I do not reside in the state of Mississippi transportation by auto to my home area will be arranged. I understand that I may have to travel to the transportation destination within my state. I agree to make the necessary arrangements to meet the transport on the day of delivery at a predetermined delivery destination set by the transport company to accept delivery of my new pet.
I have read, understand and agree to all of the listed terms and conditions.
Submit
Should be Empty: