Dalmatian Rescue Adoption Application

Please fill out all fields that are applicable for you.  If a field is not applicable just leave it blank.  We do not share information with anyone and the data is encrypted and password protected for your privacy.  Dalmatian Rescue does not discriminate based on age, sex, race, sexual orientation or religion. Dalmatian Rescue is comprised solely of non-paid volunteers with full time employment at other jobs, so our staff members usually will try and respond after 6pm when they have the chance to come home and start their nights volunteering for the rescue. Although we do try to be prompt, situations with our day to day activities may delay an immediate response, so please be patient as we really do want to chat with you as soon as possible.
 
YOUR FIRST NAME     Required
YOUR LAST NAME     Required
YOUR STREET ADDRESS     Required
YOUR CITY     Required
YOUR STATE     Required
YOUR ZIP CODE     Required
YOUR EMAIL ADDRESS     Required
YOUR HOME PHONE NUMBER
YOUR WORK PHONE NUMBER
YOUR CELL PHONE
HOW DO YOU PREFER TO BE CONTACTED
WHAT IS YOUR BIRTHDATE   Example: (MM/DD/YYYY)
HAVE YOU EVER BEEN CONVICTED OF ANIMAL ABUSE
DO YOUR RENT OR OWN YOUR HOME     Required
WHO IS YOUR LANDLORD
LANDLORDS PHONE NUMBER
WHY DO YOU WANT A DALMATIAN
WHICH DALMATIAN ARE YOU INTRESTED IN
PLEASE LIST ALL PEOPLE AND AGES IN YOUR HOME
DOES EVERYONE IN THE HOME WANT A DALMATIAN
IS ANYONE ALLERGIC TO PETS IN YOUR HOME
PLEASE LIST ALL PETS CURRENTLY IN YOUR HOME
ARE ALL OF YOUR DOGS SPAYED OR NEUTERED
HOW OFTEN DO YOU FEED YOUR PETS
WHAT DO YOU FEED YOUR PETS
ARE YOUR NEIGHBORS PET FRIENDLY
TELL US ABOUT YOUR OUTDOOR PLAY AREA
WHAT TYPE OF FENCE DO YOU HAVE
HOW LONG WILL YOUR DOG BE LEFT ALONE
DO YOU HAVE A DOGGIE DOOR
HAVE YOU USED A CRATE BEFORE
WHAT WILL BE DONE WITH THE DOG WHILE ON VACATION
WHO IS YOUR VET
WHAT IS YOUR VETS PHONE NUMBER
HAVE YOU EVER BRED A LITTER OF PUPPIES
WHAT REASONS WOULD YOU RETURN A DOG
WOULD YOU CONSIDER FOSTERING A DOG
DO YOU HAVE ANY OTHER QUESTIONS
ANY SUGGESTIONS OR COMMENTS ABOUT OUR WEBSITE