Pre-Adoption Application

Location*
- I reside within a reasonable driving distance of New Castle County, Delaware
Which dog you are interested in adopting?*
Your Name*
First Last
Your age*
Name(s) of other adults in household
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Mobile Phone
Email*
Driver's License Number*
State*
Who will be responsible for the dog(s)?*

References
List 3 references other than your vet.
Reference 1
Reference 1 Name*
First Last
Reference 1 Phone*
Reference 1 Relationship*
Reference 2
Reference 2 Name*
First Last
Reference 2 Phone*
Reference 2 Relationship*
Reference 3
Reference 3 Name*
First Last
Reference 3 Phone*
Reference 3 Relationship*
CAPTCHA
By clicking Submit below, I certify that the information I have given is true. This dog will reside in my home as a pet. I will provide it with adequate food, water, shelter, training, affection and medical care. I agree to allow a representative of Renee's Rescues visit this dog in my home, to ensure that he/she adjusts well after adoption, if I am approved. I am in full agreement with these terms of adoption.
Adoption Fee*
- I understand that the adoption fee is $350.00
Email Newsletter
- Sign me up to receive updates through email
Name
This field is for validation purposes and should be left unchanged.

THANK YOU FOR CHOOSING TO ADOPT A PET. YOU ARE SAVING A LIFE!