SQ Rescue – Adoption Application

If you are interested in becoming a foster parent for one of our rescues, please fill out a Foster Application by clicking on this link.

** Incomplete applications could result in delay in processing or denial altogether.
** You must be 21 years of age to adopt.

Name of Dog you wish to Adopt*
Your Spouse/Partner/Roommate's Name:*
Do You:*
Name & Number of Landlord:
Do you live in:*
Other Explain:
Length of Time at Address:*
Explain if Less than 2 years:
Phone Numbers - Home:*
Phone Numbers - Work:*
Phone Numbers - Cell:*
Do you have a Fenced in Yard:*
If Yes, Please explain the Type and Height:
Your Age (Must be 21):*
Age of Children:
How long in Current Occupation:*
Reason for wanting to Adopt:*
Please Explain Other reason:
How Many Hours a week do you Work:*
Where will Dog be when you are not home? e.g.,work:*
Where will the Dog be when you are on vacation:*
Explain other vacation stay plans
How many hours do you leave your pets alone each day:*
How will your Dog spend his or her days?:*
Do you currently have pets? If so, list name, breed, age, sex and temperament (including Cats):*
If so, do they get along with dogs:*
Please Explain why they do not get along with other dogs:
Are your pets spayed/neutered:*
Please Explain why your pets are not spayed/neutered:
Are your pets on heartworm prevention & flea & tick control:*
Please explain why they are not on these preventatives and controls:
Are you financially able to afford heartworm prevention, flea & tick control, and veterinary care:*
Will your new dog have yearly well check visits & vaccinations at your veterinary office:*
Name & number of vet or previous vet (please provide pets name that was cared for by this vet):*
Have you ever given a pet away, if so, for what reason:*
Under what circumstances would you consider giving up your pet:*
Please explain what those other reasons are:
Would you welcome a home visit by one of our volunteers to check on how you and your new pet are doing:*
Do you agree to return the dog to SQ Rescue if for any reason you can no longer keep him/her:*
Are you willing to make a 10 to 20 year commitment for this dog:*
Please list two references, excluding relatives, to include name, relationship and phone number:*
Word Verification: