My Dog Adoption Application

Important

You must be at least 18 years old to adopt a pet from Saving with Soul. We reserve the right to deny adoption to any person based on the answers given in this application. NOTE: Adoption fees are not refundable.

All of the following fields marked with * require an entry. If a field or question does not apply, enter N/A.

Date (mm/dd/yy) *

How Did You Hear About Us (select one)?

About My Pet of Interest

I am interested in ... *

Adopting a dog

Pet of interest name *

If none enter None

What about this pet appeals to you?

Have you met this pet already? If so, where?

About Me

First & Last Name *

Email *

Best Phone # *

Date of birth (mm/dd/yyyy) *

Driver License #/State *

Your Name on Facebook

Home Address *

Country

City

State

Zip code

My References

Provide three (3) references. Two (2) must not be relatives.

Name #1 *

Relationship #1 *

Phone #1 *

Name #2 *

Relationship #2 *

Phone #2 *

Name #3 *

Relationship #3 *

Phone #3 *

My Employment

Are you currently employed? *

Yes

Employer

Occupation *

Employer *

Length of employment at current company *

Employer's Phone # *

About My Home

Type of home? *

Rent or Own? (will be verified) *

Rental Information

Landlord name & phone # *

Will be verified

Landlord allow pets? (will be verified) *

Select Yes or No

Breed/weight restrictions? *

Select Yes or No

Breed/weight restrictions:

Please describe restrictions

My Household

Number in your household *

Any children? *

Children Ages? *

Separate with commas

My Pets

Is this your first pet? *

Do you have other pets? *

If so, how many total? *

Do you have a vet? *

Provide veterinarian info *

Clinic/Vet name & phone #

My Current Pet

Pet #1 Name *

Pet #1 Breed *

If not known enter Unknown

Pet #1 age *

Approximate age OK if not known

Pet #1 Gender *

Select Male or Female

Pet #1 Spayed/Neutered *

Select Yes or Noi

Pet #1 Vaccines current *

Select Yes or No

Pet #1 Type of pet *

Select Dog, Cat or Other

Pet #1 Enter type of pet if "Other" *

Be specific; e.g. Ferret

My Other Pet

Pet #2 Name *

Pet #2 Breed *

If not known, enter Unknown

Pet #2 Age *

Approximate age OK if unknown

Pet #2 Gender *

Select Male or Female

Pet #2 Spayed/Neutered *

Select Yes or No

Pet #2 Vaccines current *

Select Yes or No

Pet #2 Type of pet *

Select Dog, Cat or Other

Pet #2 Enter type of pet if "Other" *

Be specific; e.g. Ferret

More than 2 current pets? Bring additional information as above when we meet.

Responsibility

Who will be the main caregiver of your new adopted pet? *

Who will have financial responsibility of your new pet? *

What will you do if you cannot keep your adopted pet? *

If your situation changes and you are no longer able to keep your adopted pet, what will you do to avoid taking the pet to a shelter? NOTE: owner surrendered pets are often the first to be euthanized at overcrowded shelters.

Have you ever surrendered a pet to a shelter? *

If yes, please explain *

Negative Information? *

As part of the approval process, SWS may check with local Animal Services to see if there is any negative information on file under your name and/or address. Is there anything on record for you that might be considered “negative?”

If yes, please explain *

Dog Adoption Questions

Will You provide routine vet care? *

Select Yes or No

Will you provide monthly heartworm prevention? *

Select Yes or No

Will you provide fresh water and food? *

Select Yes or No

How many hours per day will your dog spend alone? *

Where will your dog be kept while alone? *

Where will your dog be kept when you’re at home? *

Where will your dog sleep at night? *

Fenced yard? *

Select Yes or No

Type of fence? *

Enter height and type

If no fenced yard ... *

If you do not have a fenced in yard, how will you exercise your new dog and ensure its safety while outside?

Will your dog be kept outside on a chain or tie-out? *

Select Yes or No

Do you have proper outdoor shelter for your dog? *

Select Yes or No

Do you agree your new dog will NOT be used for dog fighting or any other illegal activities? *

Select Yes or No

Are you aware your new dog may have accidents in the house and may need to be house trained? *

Select Yes or No

Agreement

Terms & Conditions

_X_ I understand that the adoption fee is non-refundable.

_X_ I agree to routine veterinary care for my pet, including monthly heartworm preventive for dogs

_X_ I agree I will not keep my dog chained in the yard;

_X_ I agree I will not transport my pet in the back of a pick-up truck unrestrained;

_X_ I agree that if my dog is kept outside, he/she will have proper outdoor shelter;

_X_ I agree to always provide fresh water and food to my pet;

_X_ I agree that I will give my new pet time to adjust to his or her new home and be understanding of accidents or other “misbehavior.”

_X_ I agree that my pet will not be used in dog fighting or any other illegal activities

_X_ I agree that if my pet is microchipped, I will complete the registration of the chip when notified to do so;

_X_ I agree to always keep a collar and name tag with my contact information on my pet;

_X_ I agree to respond to inquiries from Saving with Soul as to the well-being of my pet;

_X_ I agree that if this pet is not yet sterilized, I will cooperate with Saving with Soul to get him/her to one of SWS’s approved veterinarians for sterilization as soon as reasonably possible. NOTE Sterilization is included in your adoption fee; however some pets are not ready at the time of adoption;

_X_ I agree that if I cannot keep my pet, I will NOT rehome or surrender him or her to a “kill” shelter or give him or her away for free before contacting Saving with Soul to discuss the situation with them.

_X_ I agree that any veterinary bills incurred after adoption are my responsibility.

_X_ I understand that my adopted dog may have been exposed to kennel cough and I accept responsibility should symptoms occur.

_X_ I hereby agree to waive all rights of Subrogation and waive all rights of defense against Saving with Soul Pet Rescue, Inc.

_X_ I agree that if it is discovered that I am mistreating or neglecting my pet, or otherwise violating any of these provisions, Saving with Soul has the right to reclaim the pet.

Do you agree to all the above terms and conditions? *

Application Submission

If you selected “No, I do not agree” your application cannot be submitted

Do you have additional Information for us?

If you are concerned there might be something we discover during our research that you would like to explain, please do so below. And please understand we put this provision in place to protect our animals, not to deny an adoption unreasonably. Talk to us!

Additional Information

Approvals

Saving with Soul Conditional Approval

Any adoption approval granted is considered “conditional” until three business days following the approval. During this period, Saving with Soul may verify any and all information provided in this application, including, but not limited to a review of the Animal Services records for your name and/or address, calls to references and veterinarians, landlord verification, criminal records and online profiles.

If any information is obtained that Saving with Soul considers adverse, we reserve the right to withdraw the adoption approval and you agree to return the pet immediately, along with his or her medical paperwork. In this case, your adoption fee will be refunded.

I AGREE to the above:

By submitting this application you certify that all your information and answers are true and correct and constitutes your agreement to the above.

I am a real person *

For security verification, please enter any random two digit number. For example: 14

Saving Shelter Dogs & Cats in the Florida Panhandle

Dog Adoption Application

My Dog Adoption Application

About My Pet of Interest

About Me

My References

My Employment

Employer

About My Home

Rental Information

My Household

My Pets

My Current Pet

My Other Pet

Responsibility

Dog Adoption Questions

Agreement

Approvals

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