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| First Name: * | |||||||
| Last Name: * | |||||||
| Address: * | |||||||
| City: * | |||||||
| State: * |
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| 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. |
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| Why do you want to bring a new dog/puppy into your home? | |
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| 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. * |
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| 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 | |||
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Save A Dog, P.O. Box 1108, Framingham MA, 01701-1108 Voice: 508-877-1407 or 978-443-7282 Fax: 877-349-9254 Email: adoptions@saveadog.org |
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