Save Some Souls  
www.savesomesouls.org | info@savesomesouls.org

Please fill out the initial application for pet adoption
Email the adoption application to savesomesoulsrescue@gmail.com
 
Applicant's Name : 
Complete Address : 
Home Phone Number : 
Cell Phone Number : 
Drivers License & State (will be needed before a meeting is set up) : 
Date of Birth : 

DOG IDENTITY : 
________________

Age desired:
Sex:
Activity Level:
Is there a specific dog that you are interested in?
If yes and the dog is with our foster, please provide the name of the dog and breed : 

If yes, and the dog is still at a shelter, please provide ID of the dog you are interested in and the shelter he or she is being kept at : 

Why are you interested in this particular dog?

If no, please tell us what kind of dog you are looking for : 

Will you be willing to spay/neuter the pet and make a sterilization contract?  
 
Will you be willing to pay transport fee if outside of Houston? Transport fee can be anywhere between $150 to $175, depending on size and location.  You are also welcome to transport the pup yourself and save the fee. 

Our adoption fee is $150 - $250. We do offer reduced adoption fee for special needs dogs.  Will you be able to pay it if you are approved for adoption? 

Will you be able to send us medical records whenever we request it, even after adoption? 

How did you hear about the dog and SSS Rescue :

Please provide name and ages of all people living in the household.
Name                                                                   Age:
Name                                                                   Age:
Name                                                                   Age:

Do they share your interest in adopting a dog?

Are there children in the household? 
If no children, are you planning on children?

Have you ever adopted a dog before?
Where? 

Have your ever given a pet away before?
Where? 

Adopting a pet is a lifelong commitment. Are you willing to care for your pet for their entire life? 

Is your yard fenced?
What type and how high?
Do you have a zip line or cable run? 

How do you plan on exercising your dog?

Please list any current pets and the most recent pets you have owned:

Species (dog/cat)
Pet's Name 
Sex (M/F) 
Spayed/Neutered 
Age 
Temperament 
Any Aggression? Please describe
Is Pet still with you?
If not, What happened to the pet?

List of Deceased Pets :  

Please tell us why you want a dog:

Please provide the full name, City, State, and contact number of your current veterinarian:
 **PLEASE inform this office we will call for a reference**

Where do you plan to purchase your heartworm preventative if not from your veterinarian?

Which brand do you use?
Where do you plan to purchase your flea/tick preventative if not from your veterinarian?

Which brand do you use?

How long have you lived at your current address?

Do you rent or own?

Renters: Must provide Landlord's name/phone:
Do you have permission from your Landlord to have a dog?
If so, up to what size?

Are you Employed?
Place of Employment :

Approximate # of hours per day you are away for work: 

Where will your pet stay while you at work? 

How long will the dog be left alone daily (without humans)?

Will the dog be allowed in the house?

Where will the dog stay when you are away from the house?

Are you financially able to give your pet routine medical care (annual & emergency vet visits, monthly flea treatment, heartworm prevention, etc.)? 

Are you familiar with the use of a dog crate to train the pet during your absence or at night?

Will your dog receive formal obedience training?

Have you ever sold, given away, or surrendered a pet to a shelter?

If yes, please explain the circumstances:

Please tell us a little about your lifestyle, your family including any special activities in which your dog would be included.  (If you have any requirements or requests for a dog, please let us know so that we can more carefully match a dog to your lifestyle).

When you go on vacation who will care for your dog and where will it be cared for?

While you’re home will your pet have free roam of house or be restricted to certain areas?

Please list one professional reference (work related)
Name : 
Company : 
Address (optional) :
Phone : 
Email : 

Please list 2 personal references (Non-relative)
Name : 
Relationship : 
Address (optional)
Phone : 
Email : 

Name : 
Relationship : 
Address (optional)
Phone : 
Email : 

We do home visits prior to placement. When would be the best time for you and your family  for visit? 

Do you give us permission to contact your veterinarian for a reference check?

Yes  _______          No ___________

We have a lifetime commitment to our dogs. Do you agree for us to check on the dog anytime after adoption and ask for vet record and check to see how the dog is being maintained?
Yes  _______          No ___________

I/we attest that the information provided on this application is true and accurate to the best of my/our knowledge.

I/we understand that completion and submission of this application does not guarantee adoption of a dog. 
 
Signature : 
If submitting online, we will accept typed name as proof of signature : 

Name : 
Date :