717-359-9047

Donate Now!

Home
Adopt a Pet
Donations
Events

Application

Home / Application

Company

First Name *

Last Name *

Date of Birth *

Email Address *

Home Phone *

Cell Phone *

Do you own or rent?

Own

Rent

Address *

City *

State *

ZIP *

Please list the pets you have now(Species,Name, Age, Breed, Sex, Spayed/Neutered, Lives inside/outside, Years Owned) *

Vet Information (Name, Phone Number, Address) *

Will you give your past/current veterinary office authorization to release medical records to The Pink Dog Animal Rescue? *

Yes

Where will your pet live during the day? *

Inside

Outside

Crated

If adopting a dog, are you willing to train it? *

Yes

Do you want this pet as a? (Check all that apply) *

Companion

Gift

To breed

Mouser

Protection

Emotional Support/Guide/Service

Does anyone in your household have pet allergies?

Yes

Are you planning to move within the next 6 months?

Yes

Most shelter animals have unknown backgrounds. Are you prepared to take this pet to the Veterinarian within 21 days for necessary treatment? *

Yes

Do you understand the state and local ordinances concerning..(Check all that you understand) *

Licensing

Leashing

Rabies Law

Noise

Spay/Neuter Deposit Refund (Please check one, if you need more information on your choices please ask your pets foster)

Returned to me

Community Fund

Veteran's Program

Please provide 3 references not related to you or living in the same household and their phone numbers.

Which animal are you interested in? (Name and breed) *

Do you have experience with this breed? (If not we will talk to you about the breed to make sure he/she will fit in with your lifestyle.) *

Where will your dog stay when you are away?

What is a reason to give up a pet in your opinion?

Do you have a fenced in yard? (You are not required to have one, we just want to know how your dog will get exercise) *

Information Summary

The Pink Dog Animal Rescue

About Us
Foster Application

Adoption Information

Adopt A Pet