• Pet Adoption Application Form

    Pet Adoption Application Form

  • Format: (000) 000-0000.
  • Do you own any pets?
  • Are you open to another dog if this one is not a right fit*
  • Format: (000) 000-0000.
  • Do you own or rent your home?*
  • Type of residence
  • Do you have a yard?*
  • Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?*
  • Are you open to special needs*
  • Are you planning on moving in the next 12 months
  • Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*
  • After this application is filled out, it will go under review. If everything looks good, we will contact the applicant to schedule a meet and greet with the dog.

    • By clicking the submit button, I agree to the adoption process and interview.
    • By clicking the submit button, I understand my references will be checked including veterinary and personal.
    • By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
    • By clicking the submit button, I agree to indemnify and hold harmless the rescue center against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
    • By clicking the submit button, I understand that Rescue Center will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
    • By clicking the submit button, I verify all of the above information is true and accurate.

  • Date
     - -
  • Should be Empty: