z - Dog Adoption Application
First Name
*
Last Name
*
Spouse / Partner Name:
Address (NO PO Boxes)
*
City
*
County
*
Select County
Pulaski County
Adair County
Andrew County
Atchison County
Audrain County
Barry County
Barton County
Bates County
Benton County
Bollinger County
Boone County
Buchanan County
Butler County
Caldwell County
Callaway County
Camden County
Cape Girardeau County
Carroll County
Carter County
Cass County
Cedar County
Chariton County
Christian County
Clark County
Clay County
Clinton County
Cole County
Cooper County
Crawford County
Dade County
Dallas County
Daviess County
DeKalb County
Dent County
Douglas County
Dunklin County
Franklin County
Gasconade County
Gentry County
Greene County
Grundy County
Harrison County
Henry County
Hickory County
Holt County
Howard County
Howell County
Iron County
Jackson County
Jasper County
Jefferson County
Johnson County
Kansas City
Knox County
Laclede County
Lafayette County
Lawrence County
Lewis County
Lincoln County
Linn County
Livingston County
Macon County
Madison County
Maries County
Marion County
McDonald County
Mercer County
Miller County
Mississippi County
Moniteau County
Monroe County
Montgomery County
Morgan County
New Madrid County
Newton County
Nodaway County
Oregon County
Osage County
Ozark County
Pemiscot County
Perry County
Pettis County
Phelps County
Pike County
Platte County
Polk County
Putnam County
Ralls County
Randolph County
Ray County
Reynolds County
Ripley County
Saint Charles County
Saint Clair County
Saint Francois County
Saint Louis City
Saint Louis County
Sainte Genevieve County
Saline County
Schuyler County
Scotland County
Scott County
Shannon County
Shelby County
Stoddard County
Stone County
Sullivan County
Taney County
Texas County
Vernon County
Warren County
Washington County
Wayne County
Webster County
Worth County
Wright County
Out of State
State
*
Select State
MO
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone
*
Email Address
*
Drivers License Number & Issue State
*
If renting, are you pre-approved to have a pet?
No
Yes
1st Dog (if decided)
Athena (Dog - 25195)
Barney (Dog - 25187)
Bronco (Dog - 25192)
Denali (Dog - 25090)
Dobbie (Dog - 25067)
Grace (Dog - 25044)
Little Bit (Dog - 25219)
Loki (Dog - 25193)
Luna (Dog - 25218)
Opie (Dog - 25220)
Prancer (Dog - 25191)
Sebastian (Dog - 24983)
Serenity (Dog - 25045)
Socks (Dog - 25070)
Stormie (Dog - 25194)
Woody (Dog - 24984)
2nd Dog (if decided)
Athena (Dog - 25195)
Barney (Dog - 25187)
Bronco (Dog - 25192)
Denali (Dog - 25090)
Dobbie (Dog - 25067)
Grace (Dog - 25044)
Little Bit (Dog - 25219)
Loki (Dog - 25193)
Luna (Dog - 25218)
Opie (Dog - 25220)
Prancer (Dog - 25191)
Sebastian (Dog - 24983)
Serenity (Dog - 25045)
Socks (Dog - 25070)
Stormie (Dog - 25194)
Woody (Dog - 24984)
Adopting this canine means that the adopter agrees to provide food, water, safe harbor, kind treatment, routine veterinary care and seek prompt veterinary care in the event of illness or injury. All veterinary fees are the sole responsibility of the adopter.
*
No
Yes
Adopting this canine means that the adopter agrees to allow adequate time for him/her to settle in to a new home. In some cases it does not happen overnight. Research ways to reduce anxiety in your new family pet if you are not familiar with them.
*
No
Yes
Adopter understands that animals adopted from TNR A Better Chance dba Kitten & Puppy Division are rescued animals and most do not come with a background history.
*
No
Yes
Adopter understands that Kitten & Puppy Division cannot guarantee the future health and temperament of the canine being adopted. The adopter assumes all responsibility for treatment for any and all conditions that may occur. Kitten & Puppy Division shall not be held liable to adopter or any other party for any losses, injuries, damages, costs, lawsuits, or judgements in connection with the adoption or ownership of said canine.
*
No
Yes
Adopter understands that this canine is the adopter’s responsibility for its entire natural life.
*
No
Yes
Adopter understands that failure to perform the foregoing agreement will constitute a breach of contract. In the event of any such breach of contract, adopter authorizes Kitten & Puppy Division to reclaim possession and ownership of any and all animals adopted by applicant from Kitten & Puppy Division.
*
No
Yes
Type YES to indicate that you understand and agree that adoption fees are considered a donation and will NOT be refunded.
*
Signature
By completing and submitting this legally binding contract, Adopter certifies that Adopter has read, understands, and fully agrees to same.
Clear