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Rescue a Pet Form

Applicant Information
Family Information
Pet Information

List all of your current pets.

Type of Pet
Indoor or Outdoor?
Spayed/
Neutered?
Name
Breed
Age
Type of Pet
Indoor or Outdoor?
Spayed/
Neutered?
Name
Breed
Age
Type of Pet
Indoor or Outdoor?
Spayed/
Neutered?
Name
Breed
Age

List all of your previous pets.

Type of Pet
Indoor or Outdoor?
Spayed/
Neutered?
Name
Breed
What happened to the pet? How long ago?
Type of Pet
Indoor or Outdoor?
Spayed/
Neutered?
Name
Breed
What happened to the pet? How long ago?
Type of Pet
Indoor or Outdoor?
Spayed/
Neutered?
Name
Breed
What happened to the pet? How long ago?
Rescue Information

*NOTE* When your application is accepted and you have met your dog, you have one week to take him/her home with you. We cannot board dogs for you. Boarding adopted dogs ties up foster homes’ so that they cannot take another dog in need of rescue.

By submitting this form you are providing an electronic signature. By my signature, I certify that I have given accurate, correct information and that information is subject to verification. I also understand that the APS reserves the right to refuse adoption of any animal. I also understand that by submitting the form it becomes property of the APS of Person County and will not be returned to me.