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Displaced Pets Rescue - Adoption Application

Before proceeding with this application please note - we only place our dogs within the Pacific Northwest area,
which includes, Washington, Oregon and Idaho.  Applications from other states are discarded.

This questionnaire is intended to help us in making the best match possible. Be detailed in your answers as it will give us a better picture of you and the home you will be providing. Be patient in your answers, this information is the main part of starting my determinations. The more detail you give me the better I am able to decide if this is the right pet match. You don't want to be skipped over because someone offered more detailed responses for the same skill set.  Applications with short yes/no types of answers, or with a lot of skipped questions, are not considered.

You need to give me your complete physical address.  We are not able to process an application that does not have an address or offers a PO box.  It must be a complete physical address.

(Please let us know how you came to find us, eg: Google search, Pet Finder, PetSmart, Rescue Me, referral from Jane Doe, picked up business card at XYZ business. etc.)

If you are renting we need to contact your landlord for reference and to verify pet status in the home. Indicating their information here is your agreement to our contacting them.

Please know we take our job seriously. We will be contacting your local animal control, shelters and/or police departments, in your area, to ensure no animal related or violent issues have been filed.

This next section is information about your home, experience and training.




Please explain what you would do if your dog developed a problem with the following: We understand that it may be difficult to predict your response to each individual scenario, however we are looking for your general view on the philosophies of training. Please provide thoughtful and thorough answers. The more detail you provide the better vision I have of your skill level.


We are a non-profit organization. The adoption donation is used to partially recover the costs involved in rescuing this dog. Donations are used 100% for the dogs. Our expenses include but are not limited to: Shelter fees, spay/neuter, food, housing, vaccinations, de-worming, registered microchip, and any vet exams or medical care that the dog may have required. We would not have been able to save the life of the dog you applied for without the adoption donation from another that came before him/her. Our adoption donations range between $200 and $400 depending on the age, medical condition and place-ability of the pet.

I have read the above carefully and have filled out this application honestly. I understand that an omission and/or failure to answer all questions can result in the application being declined. If an untruth is discovered after an adoption takes place, and this untruth puts the rescue animal at risk, that animal will be removed.

Clicking this Submit button is your signature that all of the above is true and that the person completing this application is 18 or older. This application becomes part of the adoption contract.


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Compassion for animals is intimately connected with goodness of character; and it may be confidently asserted that he who is cruel to animals cannot be a good man.