Loving Spots Dalmatian Rescue
Adoption Application





Our adoption fee is $125 for dogs & $150 for puppies. This donation is based on what medical attention the dog has received. This fee is due upon receipt of the Adoption Agreement. Under certain circumstances Loving Spots Dalmatian Rescue, may request this fee as a deposit on those Dalmatians under high demand, such as puppy adoptions. If for any reason this Dalmatian is no longer able to reside with adopter, it is to be returned to LSDR. This Dalmatian will be taken back, at the request of the adopter, for any reason. LSDR is funded entirely through private/adoption donations, therefore returning a dog will forfeit any and all adoption donations.

Name___________________________________ Spouse__________________________

Address____________________________________________________________

City_________________ State_________ Zip__________

Home Phone_______________________ Work Phone__________________________

SS#________________________ TX DL#_______________________________________

Occupation_________________________________

Spouse's Occupation________________________________________

Personal Reference____________________________ Phone____________________

Veterinarian Information: ______________________________________________

________________________________________________________________________

________________________________________________________________________

Do you live in a: House_____ Apartment_____ Condo_____ Trailer_____ Rent_____ Own_____ Other_____________________

Landlord Information:___________________________________________________

________________________________________________________________

Pet Deposit:______________________________________

How did you hear about us?







Have you ever owned a Dalmatian before?_________

If yes, what happened to it?





Why do you want to own a Dalmatian?





What traits are you looking for in a Dalmatian?



Do you want a Male_____ Female_____ Black/White_____ Liver/White_____ What ever needs me_____

Your age preferences Under 1 year_____ 1 to 2_____ 3 to 5_____ Geriatrics_____ Special Needs_____

What are you looking for? Family Pet_____ Personal Companion_____ Guard_____ Hunting_____

Will this dog be Inside_____ Outside_____ Both_____

How long will dog be alone each day?



Where will dog spend most of it's day?



Where will dog sleep?



Where will dog be when you're on vacation?



Will you Obedience train your Dalmatian?_______

Will you Crate train your Dalmatian?_______

Do you have a fenced yard?_______

Describe your yard? Size





Do you have a kennel run?______

Size


What kind of exercise do you plan for dog Jogging w/owner_____ Fetching_____ Hikes_____ Exercise in yard_____ Swimming_____ Walks w/owner_____ Other_________________________ How often?


What other animals do you have? What kind and ages.





How many adults are in your house?

Name______________________________________________________Age_________

Name______________________________________________________Age_________

How many children are in your household?

Name______________________________________________________Age_________

Name______________________________________________________Age_________

Name______________________________________________________Age_________

Name______________________________________________________Age_________

Are you willing to adopt a Dalmatian that needs additional training?

Are you willing to adopt a Dalmatian with medical needs?

Are you willing to adopt a Dalmatian with special needs?

I certify that the above information is true, any false information may result in nullifying this adoption. I certify that my purpose in acquiring this Dalmatian is to have a family pet, and not for use as research, or breeding. This Dalmatian will reside in my home as a pet. I will provide adequate food, water, shelter, training, affection, and medical care. Should an unneutered or unspayed Dalmatian be place with me, I agree to have it neutered or spayed within one month of adoption, or by a date agreed upon by me and a representative of LSDR in writing. I understand that I will be required to sign a condition of Adoption Agreement and Placement Agreement. This application will become part of these agreements, and any misrepresentation in this agreement will constituted a breach of the Conditions of Adoption and the Placement Agreement. I understand that LSDR is a rescue service and is not responsible for the accuracy of information received about the temperaments, habits, or physical condition of Dalmatians available for adoption. LSDR is not responsible for any damage, accident, or injury resulting from the placement of a Dalmatian into my household.

I am in full agreement with these terms of adoption.

Signed_________________________________________________ Dated_________________

LSDR Interviewer_________________________________________________ Dated____________________

Please PRINT & FILL OUT this form
and the Adoption Agreement (if you haven't already)
& return BOTH to:

Loving Spots Dalmatian Rescue
10401 Fairview Drive Conroe,
Conroe, Texas   77385


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