SCDR Adoption Application

Second Chance Dog Rescue - Adoption Application

Please fill in the form below. This page is contact info details.
Name of pet to be adopted*
Which specific pet OR type of pet (breed, gender etc)
Name

First NameLast Name
If the specific dog you are applying for has lots of other applications (and ends up with a different adopter), do you want us to help you find a different dog that is a good fit?*

Yes, help me!No, I only want this dog!
Full Name*

First NameLast Name
Address*

Street Address

Mailing address

CityState / Province

Postal / Zip CodeCountry
E-mail*

Confirmation Emailexample@example.com
Cell Phone Number*
Home Phone Number*
Work Phone Number*
Alternate contact person*

First NameLast Name
Alternate Phone Number*
Second alternate contact*

First NameLast Name
Second alternate phone number *
What are you looking for in a pet (please be SPECIFIC and describe in DETAIL what it is you're looking for- lap dog, watch dog, guard dog, companion, good with kids, etc)*
Fantasy question: What would your dream dog be like? (If this dog is not a fit, we may be able to recommend another based on what you say here)*
What activity/energy level do you prefer?*

Calm couch potato, only needs to be walked for a few blocks each dayMedium energy, plays a bit with you and then hangs out with youHigh energy, they need to keep up with my activity level!
Do you currently have a vet you use or that can give us a reference?

YesNo
Vet Reference name*

First NameLast Name
Vet Phone Number*

**Terms and Conditions of Adoption Contract**

You must agree to all statements below to adopt from Second Chance Dog Rescue. Please read all statements CAREFULLY before signing and submitting Adoption Application.
The adopter agrees to submit a government issued ID with a current address at the time of adoption (we want to make sure we do our due diligence to ensure we know where our dogs are going)*

Yes
ALL ADOPTERS MUST AGREE TO THE FOLLOWING TERMS AND CONDITIONS (you have have to scroll through and read the conditions before you are able to click to agree to the terms) *
NON-TEXAS ADOPTERS ADDITIONAL TERMS AND CONDITIONS
By Signing here, I agree to the terms of adoption listed above and have completed this form honestly and to the best of my ability.*

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Second Chance Dog Rescue - Adoption Application