Circumstances to Consider: While playing in the front yard? In the back yard? In the neighborhood? During walks? While swimming? At the beach? At the Golf course? In local fields? At other times (please explain)
Also list any other pets you have at this time now, also list the breed, & sex and if they are spayed or neutered.

Please note that any remarks or comments made in this application that are found to be false or misrepresentations will be cause for adoption being denied. Filling out this application does not ensure you will be approved for adoption.

Applicant Signature

Co-Applicant Signature

Prior to clicking on the Submit button, review your entries and be sure that items marked with a "*" are filled out.

Once you submit the form, please be patient while the information is processed.

If your submission was successful, the screen will refresh and display a printable page showing your response to each question.

If the form fails to submit, review the form for missing information and then resubmit the form.

To be signed & dated by a STARS representative following submission of form.