Adoption Application

BEFORE filling out our Adoption Application

or if you know of someone considering adoption, we strongly recommend that you/they take a moment and view this powerful 3-minute video, “The Apology”, on pet ownership.  We invite everyone to consider the video’s factors when thinking of adding a pet to their family! Thank you for supporting animal rescue.

Full Name (required)

Your Email (required)

Your Street Address (required)

Your City, State, Zip (required)

Home Phone

Cell Phone

Why do you want a Dog?

Where will your Dog Sleep?

How long will the dog be left alone during the day?

How are you containing the Dog outside?

If you have a fence yard, what type of fence?

How tall is your fence?

Have you had other pets? What happened?

If you currently have pets, who is your Veterinarian?

If you have children at home, what are their ages?

Which of our current dogs are you interested in?

Additional Comments

Dirks Fund
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