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.
* Why are you looking to adopt a dog? (please check all that apply)
 
* Please:
 
* Are all gates locked?
* Have you recently inspected your fence and found it to be secure without holes or gaps?
* Do you object to a home visit?
* Is there anyone home during the day?
* Do you have a limit on the cost of vet treatment?
 

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

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Still Own? If no, why do you no longer have this dog? If deceased, from what illness or accident?
 
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Still Own? If no, why do you no longer have this dog? If deceased, from what illness or accident?
 
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Still Own? If no, why do you no longer have this cat? If deceased, from what?
 
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List all cats you have now & in the past 10 years. If no cat, enter "none" under cat name.

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Still Own? If no, why do you no longer have this cat? If deceased, from what?
 
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Still Own? If no, why do you no longer have this cat? If deceased, from what?
 
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------------------- General Information ----------------------
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* Do you travel often? Who would take care of your pet when you travel?
 
* Are you able to talke care of this dog for its entire life (dogs can live 10-20 years)?
* Do you expect any major changes in your life in the next five years?
If yes, please check what they might be:
 
* Under what circumstances would you not be able to keep this new pet? (Please check all that apply)
 
* If you are adopting a puppy do you promise to enroll the puppy in obedience training appropriate for it's age and size?
* Would you agree to consult and pay for a trainer if problems develop?
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.
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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