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Fill and Sign the Vsp Enrollment Form with Dependent Data

Fill and Sign the Vsp Enrollment Form with Dependent Data

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S.C.L.P. Pet Rescue Adoption Application Please be as specific & detailed as possible, answering ALL questions. 1. Name, address, and phone # (all 3 required) and email address: 2. Name/description of dog you are interested in: 3. Have you ever had a dog before? 4. If so, do you still have them: Ages & breeds, spayed or neutered? If not, what happened to them: 5. Do you live in a house, apartment, mobile home: 6. Do you own or rent (please list landlord): 7. Do you have a fenced yard? 8. Are you allowed to have pets: 9. Number and ages of adults in the home: Number and ages of children: 10. Where will the dog sleep? 11. How many hours a day will the dog be left alone: 12. Where will the dog stay when left alone? 13. Who will primarily be responsible for the dog? 14. Will you provide obedience training? 15. How will you housebreak the dog, if needed? 16. Do you currently have a vet (may we contact for reference?) please give phone number to vets office. 17. Have you ever had to give up a pet: If so, give reason: 18. Do you promise to give this animal good care and to provide it with good health care through annual vaccinations, flea and tick prevention and year around heartworm prevention by using frontline and heartgard or equivalent products. 19 What would you do with the dog if you had to move? 20. What would cause you to return a dog to the rescue? 21. How did you hear about this dog? I have completed the questions above to the best of my ability. I understand that the rescue will exercise its discretion in the placement of all animals and that completion of this questionnaire does not guarantee that I will adopt an animal. I also understand that should I need to surrender this pet for any reason during it’s lifetime I am to contact SCLP first and see if they have room to take the pet back. Adopter signature _______________________ Date _________ Thank you for completing our confidential application. When complete mail to: Debora@SaundersCountyLostPets.com s SCLP Pet Rescue 1168 North Hickory Wahoo, NE 68066

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