• Dalmatian Rescue of Southwest Virginia Adoption Application

  • The information we request in this form is to ensure that we are finding a quality permanent home for our Dalmatians.  This information assists us in achieving the best possible match between a dog and a potential new owner.

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  • By clicking the box below, you agree to & understand the terms of this form.  

    1. If I am approved for adoption and I cannot keep the dog for any reason, it will be returned to Dalmatian Rescue of Southwest Virginia immediately.
    2. I am authorizing, through submission of this form, the Veterinarian(s) named above to release any information and records concerning past or present care of animals to Dalmatian Rescue of Southwest Virginia. I agree to hold harmless and indemnify said Veterinarian(s) for providing such information.
    3. I have not, nor has anyone in my household, ever been charged with any forms of animal abuse, neglect or cruelty.
    4. I am at least 18 years of age and I have read this application in its entirety and have answered each question honestly and to the best of my ability.

    Dalmatian Rescue of Southwest Virginia debi.smith@drswv.com

     

  •  - -Pick a Date
  • Thank you for taking the time to submit this form.  

     

    Please feel free to contact DRSWV with any questions.  After you click the Submit button, you will be redirected to the main page and you will receive a confirmation email. 

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