PO Box 22, Auburn, KS 66402 (785) 256-2976		Home	Facilities	Contacts/Donate	What’s New
Sponsor Adopt Me Success Stories Links Online Store Guestbook ----------- Newsletters Adoption Application Web Rings	Adoption Application If you are interested in adopting any of our dogs, please fill out the application below. Please fill it out as completely as possible, as we make decisions about adopting out our dogs based on this information. When you have completed the form and are happy with your entries, click the ‘Enter’ button at the bottom to submit your application. ALL FIELDS MUST BE FILLED OUT. PLEASE BE THOROUGH! (enter N/A for fields not applicable) ---------------- Information about you: First Name: Last Name: Address 1: Address 2: Address 3: City: State: Zip: Home Tel: Alternate Tel: Fax: Email: How long have you lived at this address? Do you rent or own your home? Rent Own If you rent, name/telephone of landlord? Are pets allowed at this address? Yes No Please provide names and ages of everyone living in your home*: (separate by commas) Primary Care Giver for the pet(s): Why do you want to adopt a pet?: Applicant’s Employer: Length of Employment: Work Telephone: Information about your current pets: How many pets do you have?: List pets by name/age/species/temperament, and (if dog or cat) indicate if they are spayed or neutered: (example – Buddy/dog/friendly/neutered, Chelsea/dog/submissive/not spayed, etc.) Do your pets regularly see the veterinarian?: Yes No Veterinarian Information: Name: Address: Phone: If you have had pets in the past, please tell us about them (names/species/what happened to them): (example: Sam/dog/died of old age, Missy/dog/hit by car) Information about the animal(s) you want to adopt: Name(s)/description(s) of dog(s) you are adopting: (taken from ‘New Arrivals’ or ‘Adopt Me’ page) OR Description of dog(s) you are looking for: References: (example – John Smith, friend, 22 Any Place, Sunnydale, KS 66123, (785) 111-1111) Please read the following before submitting the application: 1. I agree to have this dog spayed or neutered by age 6 months if the dog has not already been spayed or neutered. 2. I agree that the dog I am adopting will be kept in a fenced yard, never on a chain or running loose. This is for the dog’s safety. 3. I agree to keep a collar with identification tags on the dog at all times. 4. I agree to keep the dog on a leash at all times when the dog is taken out in a public area which enforces a leash law, any area which required total control over the dog at all times, and any area which requires the dog to be leashed at all times when walked in residential area. 5. I agree to obtain medical care fo the dog whenever needed. 6. I agree to begin heartworm preventative at four months of age when receiving the rabies shot as required by law unless my veterinarian recommends otherwise. The dog shall remain on heartworm preventative indefinitely throughout the entire lifespan of the dog. The dog shall also have yearly booster shots from the veterinarian. 7. If the dog is to reside outdoors, I promise to provide the dog with adequate shelter both summer and winter, straw in the winter and adequate food and water within reach at all times. I also promise to bring the dog inside during frigid weather. During the summer the dog must be provided with adequate shade from either trees or man made shade. By checking the following box, I agree to the above provisions (click on the box to agree): I agree If you have completed and reviewed your application, click the ‘Enter’ button to submit it: Home | Contacts & Donation | Sponsor | Adopt Me | Success Stories Facilities | Links | Web Rings | What’s New | On-line Store | Adoption Application | Guestbook Please contact us with you questions/suggestions at contact@scarsusa.com.