Dog Adoption Application

dog adoption application

If you prefer to download a printable application you can return it by mail (P.O. Box 316, Horn Lake, MS 38637) or scan it and email it (info@desotoanimalrescue.org)
Dog Adoption Application

Please note: Some people have reported problems submitting this application using a tablet, phone or dsl (bellsouth, at&t, etc) connection. If you do not see a confirmation notice after hitting the submit button then your application did not go thru. Please try again or email us here: info@desotoanimalrescue.org for further instructions.

Please note that failure to answer all questions completely may negatively impact our ability to adopt to you.

What is the name of the puppy or dog you would like to adopt? *

What interests you about this animal and what do you expect them to do for you and/or your family? Why This Animal and why should You be chosen to be their family? *

Name *

First

Last

* Indicates required field

Age of Applicant *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

What is the best time to contact you? *

Applicant's Employer and position *

Email *

Name of co-applicant if applicable *

First

Last

Co-Applicant's Phone Number *

Co-applicant's Employer and position *

Number of Adults living in your home: *

Number of Children living in your home: *

Please list the ages of the Children in the home, if any: *

Is there usually someone home during the day? *

Yes No Sometimes

Is anyone in your home allergic to dogs? *

Yes No

If so, how do you plan on addressing that? *

How would you describe the local of your home *

What best describes the street you live on *

Which of these describes your living conditions: *

If you chose other, please explain: *

How long have you lived at this address? *

Do you plan to move within the next 6-12 months? *

Yes No

If you rent or live in someone else's home, please provide their Name and Contact Info (A Renter cannot be considered without this information). *

Which of the following will your new companion be? *

Indoor Indoor/Outdoor Outdoor

Which of these are you looking for in a new companion? *

Long Hair Medium Hair Short Hair Doesn't Matter

All animals shed to some extent. Is this a big concern for you? *

Yes No I'm not sure

Please list any other Characteristics (Personality, Temperament, Physical Traits, etc.) that are important to you in the Puppy or Dog you choose to adopt: *

Please tell us why you're looking to adopt this animal (i.e. cuddle buddy, jogging companion, guard dog, gift for someone else, train as a service animal, hunting, etc.): *

Will the dog be allowed outside without you? *

Sometimes Quite Often Never

If so, how will it be restrained (fence, tie out, free roaming, etc.)? *

If you have a fenced yard, is it: *

Is it made of: *

If other, please describe: *

In a normal 24hr, how long would the dog be left alone? *

When alone, will the dog be: *

If Other, please explain: *

Where will the dog sleep at night? *

Please describe any and all behaviors that would cause you to return an animal: *

How will you discipline the animal when they do something wrong/unwanted? *

Are you willing to Crate Train to address problem bahavior *

Yes No I think that's cruel I don't know how

Are you willing to attend Obedience Training with your companion animal if problems persist? *

Please list every other animal currently living in the home and include their Name, Age, Type (cat, dog, etc.) and if they are Male or Female. *

Which, if any of these are outside animals and are they mostly or always? Please give details. *

Are All of your Current pets Spayed or Neutered? *

Are all of your current animals up to date on their Annual and Rabies Vaccinations? *

Do all of your other animals receive monthly Heartworm Preventative? *

Who is your Vet for your current animals? Please include the Clinic Name, Location and Phone Number: *

Additional Name the vet records could be listed under: *

In addition to the above animal(s), please list ALL Animals you've had in the last 10 years, but that no longer live in your home, for any reason. Please include their Species & Breed, Length of Companionship: *

How long ago did the companionship end and how? *

Who was your Vet(s) for these animals (list as many as needed)? Please include the Clinic Name, Location and Phone Number *

Additional name the vet records could be listed under: *

Have you had any animals die in your home in the last 6 months of Parvo, Distemper, Panleukopenia, FeLV, FIV, Heartworm Disease or any unknown diseases? If Yes, please elaborate. *

Who will be responsible for the care of the animal you wish to adopt? *

What are the hobbies of the members of the household? *

How often do you travel? *

Who will care for the animal when you travel or become incapacitated for any reason? *

Are you prepared to name a conservator for the pet in your will? *

Yes No I have no one to take them in case of my death

What will happen to the Adoptee if you have to move? *

If other, please explain *

Have you adopted from DARS before? *

Yes No

Have you ever had to return an animal to a Shelter or Rescue Group? If so, Please describe the circumstances: *

The cost of pet ownership can get quite expensive. Costs include Vet Care, Medication, Food, Heartworm Preventative, Flea Control, etc. How much can you comfortably spend each year? *

We require a home visit prior to completion of the Adoption Process. Is this acceptable to you? *

Yes No I'd Rather Not

If the Adoption is completed, will you consent to occasional contact to assess the animal's welfare? *

Yes No I'd Rather Not

How long have you been looking for a companion animal? *

Please tell us how you learned of this animal? *

If 'Other' please state here: *

By submitting this form, you acknowledge that you have read this adoption application completely, comprehend it fully, know that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application or the adoption contract can result in the forfeiture of the animal adopted. You agree that by hitting Submit the action represents your electronic signature.

ATTENTION: If you do not see a CONFIRMATION after hitting submit, then your application did NOT go thru! Please try again using a desktop, laptop or different service provider or contact us for further instructions.
We're sorry for the inconvenience.

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