Adoption ApplicationThank you for your interest in adopting a new member of your family. Our goal is to get pets into responsible, loving, permanent homes. Please fill out the adoption application so that we may find out more about you and your family, so that both you and your dog may find the right fit. Please Note: We are committed to matching the right dog to the right family so all will have many happy years together. Our adoption process includes the completion of an application, meet and greet, home visit, veterinary reference, adoption fee and contract. Our adoption fees vary from 100.00 to 400.00 depending on medicals and different circumstances of the pet and type of pet since we are an all animal, all breed rescue. We are a 501c3 organization and the adoption fee is 100 % tax deductible which includes all vaccinations, spay/neuter, Heartworm test, deworming and microchip.Is there a particular pet or breed you are interested in? If so, please name.Name First Last Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Home PhoneCell PhoneFL Driver's License # or Valid I.D. #Employer Name Employer Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Length of EmploymentAre You a Full Time or Seasonal Florida Resident? Full Time SeasonalType of HousingSingle Family HomeMobile HomeDuplexApartmentCondominiumDo You Own or Rent?* Rent OwnDoes Your Landlord or Association Allow Pets?* Yes NoLandlord Name First Last Landlord PhoneWeight Limit for Dogs, if anyIs a Pet Deposit Required? Yes NoAmount of Deposit:Do You Have a Fenced in Yard? Yes NoDo You Have a Pool? Yes NoDo You Plan on Moving in the Next 6 Months? Yes NoIf You Move, What Will You Do With Your Pet(s)?Do You or Does Anyone in Your Household Have Allergies or Asthma? Yes NoAre You Adopting This Pet for Yourself or Someone Else? Myself Someone ElseWhat Member of the Family Will Be Taking the MAJOR Responsibility of Caring for This Pet?List the Names, Relationship, & Ages of Members of Your Household. (Include Yourself)NameAge Have You Ever Had a Cat or Dog? Yes NoList All the Animals You Currently HaveNameType of AnimalAgeSexSpay/Neutered?Shots Current? List Any Animals You Have Previously Had That Are No Longer With YouCat or Dog?NameAgeReason No Longer With You Present Veterinarian Name First Last Veterinarian Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Veterinarian PhoneHave You Ever Turned in an Animal to a Shelter? Yes NoWhy Did You Turn the Animal In?Have You Ever Put a Dog to Sleep for Any Reason? Yes NoWhy Did You Put the Dog to Sleep?Is Anyone Home During the Day? Yes NoWho?Have You Considered Adopting Two Similar Pets to Keep Each Other Company? Yes NoWhere Do You Plan on Keeping Your Pet While You are at Work or Not at Home?What Will You Do if Your New Pet Doesn't Get Along With Your Current Pet(s)?How Long Will You Give Your New Dog to Adjust to it's New Home?If Your Family Status Changed (new baby, married, divorced, job loss, relocation) Who Would Keep the Dog?If something Happens to You (sickness, death, etc. ) and You Cannot Take Care of Your Pet(s), Who Will Take Care of Them?When You Go on Vacation, Where Will Your Pet(s) Go, and Who Will Take Care of Them?What Do You Think Are the Most Important Responsibilities of Owning a Pet?Please Supply the Name, Address, and Phone Number of Two Personal References (non-relatives).NameAddressPhone Add Any Additional Information You Feel is ImportantI certify that the information I have given above is true and correct, and I hereby authorize the above listed Veterinarian(s) to supply information in regard to my I also give my permission to contact the above listed landlord and references.* I agree.Applicant Signature* Application DateApproved By Approval DateCaptcha