Second Chance Animal Center

Second Chance Animal Center

DOG ADOPTION APPLICATION
Depending on when this application is received and any landlord or veterinary checks we need to complete, processing can take 2-4 days. We will contact you via email with your application result.
Adopter's Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mailing Address (if different):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Background Information:
Adopting a dog brings with it a lot of responsibility, including annual veterinarian visits, vaccinations, and possible emergency care. This is more expensive than many people realize. Are you aware of and prepared to assume the responsibilities for your newly adopted dog?*

YesNo
I currently own a
For how long?
I currently rent a
For how long?
Landlord's Name

First NameLast Name
Landlord's Phone Number

Area CodePhone Number
I currently live with family or friends in a
For how long?
Home Owner's Name

First NameLast Name
Home Owner's Phone Number

Area CodePhone Number
Are you a first-time dog adopter as an adult?

YesNo
If NO, how many dogs have you lived with?
List Veterinarian References:
Have you ever adopted an animal from SCAC?

YesNo
If yes, what type of animal?
When?
Have you ever surrendered an animal to SCAC?

YesNo
If yes, what type of animal?
When?
Why?

List all pets currently in your household or pets you have owned in the last 5 years.*

*If you currently have a dog(s), we ask that you bring it/them in to meet the potential adoptee.
I also live with

Other petsChildrenOther adults
Describe any other pets:
How many children and ages:
Other adults, how many?
Do you or anyone in your family suffer from allergies?

YesNo