Do you know your state and local ordinances concerning licensing?
No
Yes
No
Yes
Leashing?
Please provide the full name, address and phone number of your veterinarian:
Where do you purchase heartworm preventive if not from your veterinarian?
How much do you expect to spend each providing for your dog (food, toys vet visits, etc.)?
Have you ever given a pet away or surrendered a pet to a shelter?
Yes
No
If yes, please provide details:
Have you, or any member of your family/household ever been cited for licensing or leash law violations or
cruelty to animals?
If yes, provide details:
Yes
No
May we visit your home prior to application approval?
Yes
No
If yes, please tell us convenient days and times
If this adoption is approved will you allow SFAWG to place a picture of you and your new animal in the "success
stories: section of our web page?
Yes
No
I/we attest that the information provided on this application is true and accurate to the best of my/our
knowledge.
I understand that the adoption fee is $150.
I understand that SFAWG reserves the right to refuse any application.
Applicant Signature
Date
Co-applicant's Signature
Date
Saint Francis Animal Welfare Group
P. O. Box 68434, Nashville, TN 37206