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PET ADOPTION APPLICATION - PRINTABLE VERSION
Please print this form, complete it & mail to:

Save-A-Dog, Inc.
HCR1 Box 306
Brodheadsville, PA 18322

In order to be considered as an adopter, you must:

** Be 21 years of age or older
** Have identification - Driver's license - showing present address
** Have the knowledge and written consent of your landlord, if renting
** Submit to a home visit by a representative of S.A.D.
** Be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet.

Completion of this application does not guarantee adoption of a S.A.D. dog.

Name of dog you are applying for:  ___________________________________________________________

Your Name: ___________________________________     Age: ______________    Date:  _____________

Street Address: __________________________________________________________________________

City:  ______________________________   State:  _______________   Zip: _________________________ 

Daytime Phone#   ____________________________   Evening Phone#  _____________________________ 

Your email address:  ______________________________________________________________________

Please describe the dog you would like:  _______________________________________________________

_________________________________________________________________________________________

Will this be your first pet?     __________________   Do you own a dog now?   _____________________

If so, what kind and how many?  _______________________________________________________________

Have they been spayed or neutered?  __________    If NO, why not?  _________________________________

What happened to the dogs you no longer  have? __________________________________________________

If you have pets, will they adjust to a new animal in the house? _______________________________________

Why do you want this dog? ____________________________________________________________________

How many adults are there in your family?   __________   Children & ages: _____________________________ 

Do you rent or own your home?   Rent _______     Own _______

If renting, landlord's phone # ___________________________________

Who is or will be your veterinarian?  ______________________________________________________________

Vet's phone # or address:  ______________________________________________________________________

Do you have a completely fenced yard?   _________________________________________________________  

Where will this dog be kept during the day? ________________________________________________________

Where will this dog be kept at night? _____________________________________________________________

DO YOU UNDERSTAND AND ARE YOU WILLING TO TAKE RESPONSIBILITY FOR THIS DOG  FOR
 THE NEXT TEN TO FIFTEEN YEARS OF IT'S LIFE?   __________________________________________

Signature  _____________________________________________________________