Adoption Application

Full Name*

First NameLast Name

Age*

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home

Area CodePhone Number

Phone Number - Cellular*

Area CodePhone Number

Dog you are interested in adopting:*

Do you live in a:*

Do you:*

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

Describe your Homes Activity Level*

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?*

YesNo

Are all members of your Family agreeable to adopting a Dog?*

YesNo

Do you understand the financial responsibility of adopting a dog?*

YesNo

List reasons why you would return a dog*

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm, Living/Deceased)*

Do you have a preference in sex of a dog?*

MaleFemaleNo Preference

Are you willing to adopt a dog of any age?*

YesNo

If not, what age would you consider?

What size dog are you willing to adopt? (Check all that apply)*

SmallMediumLarge

Please describe the type of dog you are willing to adopt (Please include breed, coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our adopters.

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?*

YesNo

Are you willing to use a crate for a dog if recommended?*

YesNo

Do you have a fenced yard?*

YesNoPartial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

How many hours in a day would the dog be left alone?*

What are you plans to exercise your dog? Please list any parks near by or trails, how many walks a day, approximate length, and activities.*

Vet Reference (If you have a Vet):

First NameLast Name

Phone Number

Area CodePhone Number

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail*

Phone Number*

Area CodePhone Number

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail*

Phone Number*

Area CodePhone Number

· By clicking the submit button, I agree to Save the Satos adoption process, will undergo a homecheck, and interview at the discretion of Save the Satos.

· By clicking the submit button, I understand Save the Satos will check my references including veterinary and personal.

· By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Save the Satos 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 understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Save the Satos by email and provide a 14 day period to allow Save the Satos to make arrangents for my pet to be taken back into rescue.

· By clicking the submit button, I agree to indemnify and hold harmless Save the Satos 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 Save the Satos 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 understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Save the Satos and provide transport to where Save the Satos deems appropriate.

· By clicking the submit button, I verify all of the above information is true and accurate.

Date*

MonthDayYear

Electronic Signature*