• Example: 01/22/1978

  • Example: 01/22/1978
  • Employers Name:

  • Please include the name, species, sex, if they are spayed or neutered, and the age.
    *Please contact your vet and give them permission to release information to a Last Chance Representative.
  • Please list two (NON-RELATED) personal references that we may contact:
    Our rescue animals make wonderful pets and usually adjust quickly to their new families. To create great outcomes, we foster animals with members of our group, council adoptive families and make recommendations that help our adopters to make the right decision for themselves and their new pet. We require a $400 adoption donation from all adoptive families at time of adoption to help cover the cost of preparing the dog for his/her new home. We spay/neuter all animals prior to adoption. LCAR is a non-profit animal rescue organization that rescues from animal shelters; as such Last Chance Animal Rescue cannot and does not warranty the health or breed of the animal. Please fill out the application to help us get to know you, your family and your lifestyle. This information will assist us in matching you with one of the rescue pets awaiting adoption.
    A $400* non-refundable ADOPTION FEE includes:
    • All animals spayed / neutered
    • Vaccines up to date
    • Dewormed
    • Heartworm tested, pups 6 months and older
    • Current on heartworm preventative, if old enough
    • Flea/tick control applied
    • Boarding and transportation from shelters
    • Microchip
    *Limited ability to take credit cards, no checks
  • (Type name to sign)
  • Date Format: MM slash DD slash YYYY