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ADOPTION APPLICATION
Note: Due to certain PC and ISP settings,
some people may need to print
and mail this form.
You may also download the Microsoft
Word 97/2000 Form
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| Why do you want to own a Dalmatian? |
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Have you ever owned a Dalmatian
Yes
No
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| TYPE OF DALMATIAN YOU ARE LOOKING FOR? |
| Do You Prefer:
Male
Female
No Preference |
| Color:
Black Spots
Liver Spots
No Preference |
| Age Range:
<1yr.
1-3yr.
3-5yr.
Older
No Preference |
If you are interested in a particular dog(s) that we
have listed, please write the name(s)
here:
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| How long would you be willing to wait for the right
match?
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| ADOPTER INFORMATION
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| Responsible Adopter(s):
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| Occupation:
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| Work Hours:
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| Email Address:
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| Address Dalmatian will be living:
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| City:
State
Zip:
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| Home Phone:
Alternate Phone:
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| Do you:
Own
Rent Type of residence: |
| If rent, landlord name
Phone
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How many people reside in your home? (including children)
How many of the above are children?
Ages of children (if applicable)
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| Does anyone in your home have allergies
:
yes
no
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| Are you planning on moving within the
next 4 years?:
Yes
No
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| If you move in the future, what will you do with the
dog:
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| HOME ENVIRONMENT |
| Do you have a COMPLETELY fenced in yard?
Yes
No |
| If YES, how high is your fence?
Type of fence
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If NO, how will you contain your dog to your property?
(Be specific)
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| On average, how many hours will the
Dalmatian to be
left alone?
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| Will the Dalmatian be confined to a
crate or room when no one is home?
Yes
No
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| Where will you keep the Dalmatian when
you are sleeping?
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What will you do with the dog if you need to travel
(vacation, business, etc)?
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| PET EXPERIENCE |
Please list and describe all current animals you
own.
Please include information such as Type/Breed, Age, Sex, and
describe and behavioral issues this animal may have: |
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| CURRENT VET INFO
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| Current Vet & Clinic
Clinic Phone #:
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| Address:
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| City:
State
Zip:
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| Willing to enroll dog in obedience class
Yes
No If Yes, where:
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If no, what are your plans for training the dog?
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How do you plan on exercising the dog?
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| Adoption Fees are as follows: |
Puppies and Dogs up to 6 years - $200
6 years and over - $150
Deaf - $150 |
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I/We understand a
visit to my home by a Dal-Savers representative is required before
any adoption can
be finalized. I/We acknowledge that all the information contained
on this form is true and correct.
I/We understand that any misrepresentation
of fact may result in removal of the adopted dog from my
home by
Dal-Savers Dalmatian Rescue, Inc.
By dating and clicking submit, I/We agree to the above statement.
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| Date:
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