Navigation

How To Help
Adopt a Dog
Training
Contact
Shop
About us
FAQ

How To Help
Adopt a Dog
Training
Contact
Shop
About us
FAQ

Cart 0 items for $0.00

Wishlist

How To Help
Adopt a Dog
Training
Contact
Shop
About us
FAQ

Adoption Application

Home / Adopt A Dog / Adoption Application

â€¹Return to Previous Page

Email *

If you have a specific dog in mind enter it's name here:

Name *

First

Last

Please Enter Your Date of Birth *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How long have you lived at this address? *

Main Phone *

Alternate Phone

Which are you interested in? *

Adoption
Foster
Both

About Your Home

Are you permitted to keep pets at your home? *

Yes
No
Not Sure

Do You Own or Rent? *

Own
Rent

Landlord Name *

First

Last

Landlord Phone *

Landlord Email

Do you have a fenced in yard? *

Yes
No

How tall is your fence?

3-4 Feet
4-6 Feet
6-10 Feet

Do you have a pool? *

Yes
No

Is your pool fenced in?

Yes
No

Is a Pet Deposit Required at Your Residence? *

Yes
No
Not Sure

Has Your Pet Deposit Been Paid?

Yes
No

Are there any restrictions as to the number of dogs and /or combination of dogs and cats that you may have at your residence?

Yes
No

Please provide details of the restrictions

Please let us know if any other people live at your address and list their ages. *

Do you or anyone in the home have pet allergies? *

Yes
No

Please provide details of the allergies.

Do you currently have any other pets?

Yes
No

Please provide details on your other pets including age and breed.

Are all the pets spayed and or neutered?

Yes
No
Not Sure

Are these pets current on all vaccinations and on heartworm preventative?

Yes
No
Not Sure

Veteterinarian Info

Do you currently have a Veterinarian? *

Yes
No

Have you had a veterinarian in the past?

Yes
No

if you have no history with a vet, please indicate here how to locate past animals health records

Veterinarian Name

First

Last

Please provide the name of your Veterinarian.

Veterinarian Phone

Please provide the number to your veterinarian

About Your Schedule

Are you currently Employed? *

Yes
No

Who is your employer?

Are you a frequent traveler? *

Yes
No

Is someone home during the day? *

Yes
No

Who will watch your pets when you are away? *

Where will the dog spend its time during the day? *

Approximately how long will dog be alone each day? *

0-4 Hours
4-8 Hours
8-12 Hours

How many years experience do you have with Dogs? *

Please enter a number

Have you ever been bitten or attacked by a dog? *

Yes
No

Please provide brief detail how you were bitten/attacked

Are you comfortable approaching dogs that you don't know? *

Yes
No
Not Sure

Are you willing to assume the risks involved with animals who are sometimes frightened when in unfamiliar surroundings and may become aggressive? *

Yes
No

References

Personal Reference Name *

First

Last

Personal Reference Phone *

What is your relationship to this person?

Business / Work Reference - Name *

First

Last

Business / Work Reference - Phone *

How are you associated with this person? *

Reference Three of your choice *

First

Last

Reference Three Phone *

What is your relationship? *

How Did You Hear About Us?

Name

Pit Of Our Souls Rescue

We are a 501c3 Non-profit Animal Rescue that deals primarily with dogs from our local shelters who are in need of forever homes. We will never turn away a dog in need of any breed, size or type.

Save A Dog

Just as much as we are here to rescue, we are here to educate and work to change the immediate image and stereotypes people have of rescued dogs.

Contact information

Levittown, NY 11566
Phone: (516) 308-6221

Back to top

Search

Use the search box to find the product you are looking for.

Cart

No products in the cart.