Happy Tails Ahead!
Applications are mandatory to be considered for pet adoption through Last Chance Rescue. Due to the volume of interest we typically receive, we do not have the capacity to respond to each and every application, however, we will contact applicants that we feel are the best match. Thank you for your understanding and interest!
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Email *
Pet Applying For *
Applicant(s) Name *
Primary Phone *
Alternate Phone (If Applicable)
Address *
City, State *
Primary Applicants Driver's License State & Number (proof of identification required at time of adoption) *
Employer *
Employer Address *
Employer Phone Number *
Co-Applicant's Employer, Employer Address, & Employer Phone Number (if applicable)
House & History
Please enter to the best of your ability. If a question does not apply, please enter "N/A"
Length of Time at Current Address *
Do you own your home? *
Landlord's Name (if applicable)
Landlord's Phone Number (if applicable)
Number of Adults in Household *
Number of Children in Household/Ages *
Do you currently own any pets? If so, please include species and age(s). *
Have you owned other pets in the past? How long did they live and what was their cause of death? *
Have you ever turned an animal into a shelter? If yes, what were the circumstances? *
Veterinarian Name *
Veterinarian Phone Number *
Please provide the name and phone number of a personal reference who is not related to you (1 of 2 required) *
Please provide the name and phone number of a personal reference who is not related to you (2 of 2 required) *
On average, how many hours per day will your pet be home alone? *
Cat Adoptees: Do you intend to declaw the cat? *
Dog Adoptees: Is an area of your yard completely fenced? *
Dog Adoptees: If yes, what height is your fence?
Dog Adoptees: If you do not have a fence- in yard, do you have an outdoor dog run? *
Dog Adoptees: Where will the dog live? (Select All that Apply) *
Dog Adoptees: Are you familiar with heartworms? *
Dog Adoptees: Will you provide a heartworm preventative? *
Adoption Application Agreement
I certify that the preceding information that I have provided is accurate and honest.
Is there anything else you would like us to know about your application?
(1)  I understand and agree that the care, feeding, training and well-being of an animal is an ADULT RESPONSIBILITY.  (2)  I hereby authorized the release to Last Chance Rescue, Inc., all veterinary records of any and all animals I have had or currently have.  (3)  I understand that I may not be able to adopt the pet I have chosen if this animal would not be a good match due to lifestyle or housing concerns.  (4)  This application remains the property of Last Chance Rescue, Inc.  (5)  Last Chance Rescue, Inc. reserves the right to refuse adoption to anyone. *
Please type your full name in agreement with the above statements. *
A copy of your responses will be emailed to the address you provided.
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