Save A Dog DOG Adoption Application

You must be at least 21 years old and have a valid driver's license or picture ID to adopt.

All fields indicated by a red asterisk must be completed.

IF YOU ARE APPLYING FOR A CAT, PLEASE DO NOT FILL OUT THIS APPLICATION. CLICK HERE INSTEAD.

	First Name: *
	Last Name: *
	Address: *
	City: *
	State: *	SELECT ONEAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming   Zip Code:*
	Home Phone: *
	Work Phone:
	Cell Phone:
	Email: *
	Occupation:
	Our dogs are placed in the New England area ONLY. Please check Petfinder for another Rescue group if you live outside of this area.

	Why do you want to bring a new dog/puppy into your home?

	Please provide the contact information of a veterinarian you have used before and plan to use with your new dog. Vet references are checked.
	Vet name & phone number:
	Vet. records are under the name of:

	Please provide at least two personal references. Include their name, telephone number and how this person knows you and your ability to provide a good home for a dog. *
	1. 2.

	Please list place of employment for yourself and your spouse, if applicable. Include the location of each employer.
	My Employer is:
	Spouse's name:
	Spouse's Employer:
	Residence: *	Own   Rent   Live With Parents

Please note: If you own, proof of ownership will be required for the adoption process. If you rent, you must provide your landlord's contact information below so that we may verify that you are allowed to have a pet.

	Total number of people living in your residence (including yourself) * :
	1   2   3   4   5   6   7   8   9   10   11   12
	Do you currently have children living at home? * :   Yes   No
	Do you have 1 or more cats? * :   Yes   No