Southern Counties Rescue ~ Dog Adoption Application

Thank you very much for taking the time to complete the application. I would appreciate it if you answer every question. Please give as much detail as possible, providing phone numbers and appropriate contact persons where requested. In most cases the adoption fee is a minimum donation of $325 and it is less than our expenses. You must be 23 years of age or older to adopt. Completion of the application doesn't guarantee adoption. 
All dogs are spayed/neutered, microchipped, current on vaccinations, dewormed and flea free.
Driver's License information will be requested when you adopt. Please have your driver's license with you.
 
 
 

List all dogs you have now & in the past 10 years. If no dog, enter "none" in Dog 1 Name.

0/250 characters
 
------------------------------------------------------------------------------
0/250 characters
 
------------------------------------------------------------------------------
0/250 characters
 
------------------------------------------------------------------------------
0/250 characters

List all cats you have now & in the past 10 years. If no cat, enter "none" under cat name.

0/250 characters
 
0/250 characters
 
0/250 characters
------------------- General Information ----------------------
0/450 characters
 
 
 
THIS APPLICATION BECOMES PART OF OUR CONTRACT:
 I certify that all the above information is true and accurate. I understant that if I adopt a pet from Southern Counties Rescue, this document will become part of the adoption record.
calendar
Thank you for completing this Application. Someone should get back to you within 2 days. If you do not hear from someone please email soCountiesRescue@att.net. Please remember we are all non-paid volunteers with other jobs.
* Indicates Response Required