Ready to Adopt?

How to adopt from us —

Thank you for considering Rescue Revolution of Mississippi as you think about adopting a new member of your family.

We would love to match you with a great rescue dog. Our goal is to get dogs out of kill shelters, off chains, out of pens, and into responsible, loving, permanent homes, and to find you a loving companion who is a great fit for you.

The first step in the process is to choose the dog you would like to adopt and then fill out the application completely. This helps us to find out more about you and your family so that it’s a great fit for a wonderful life together.

After we receive your application, there are several more steps to ensure ensure that you and your new pup live happily ever after together:

You complete our application below
We check your veterinary reference
If you rent, we check your landlord’s approval to have a pet
One of our volunteers performs a home visit (remote options for Covid-19 safety)
After approval – you pay adoption fee and sign adoption contract. This contract specifies that you’ll take care of your dog and return him or her if you are unable to keep them.

Fees as of October 2020: Adoption fee: $150

Our adoption fee includes spay/neuter, all age appropriate vaccinations and necessary health testing at the time of adoption. If you would like your pet microchipped as well, there is an additional $20 fee. Our microchips include a lifetime registration through AKC Reunite.

Please note that incomplete applications cannot be processed so be sure mark your answers clearly. If the question does not apply, just put N/A. This will help expedite processing so we can get you and your dog started on life together as soon as possible while ensuring it’s a happy match.

We are committed to matching the right dog to the right family so all will enjoy many happy years together.

Adoption Application

Please fill out the application below to get started – we’ll be in touch shortly.

What pet are you interested in? *

Date of Application *

How did you hear about Rescue Revolution of Mississippi? *

Tell us a little about yourself

Name of Applicant *

First

Last

Your Age *

Applicant's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone *

Cell Phone *

Driver's License Number and State of Issue *

Email *

Your Employment

Place of Employment *

Occupation *

Work Phone *

Tell Us About Your Home

Do you have a spouse, partner or roommate? *

Who will be primarily responsible for the pet's care? *

Applicant
Spouse/Partner/Roommate
Other

If other, please give further details:

Do you have children? *

Is anyone in your home allergic to pets? *

Now we'd like to know more about what you're looking for in a pet

Reason for adopting *

Do you have any concerns about adopting? (Enter no if no concerns) *

Please describe your ideal pet in regards to age, sex, size, breed, activity level, and basic personality traits. *

Tell us more about your residence

Type of residence *

House (neighborhood)
House (with acreage)
Mobile Home
Apartment / Condo

Years at current residence *

Do you own or rent? *

Own
Rent

Do you have a yard? *

Describe how will your pet be housed / confined *

What will you do with your pet while you are at work? *

Where will your pet be kept during the day? *

Where will your pet sleep at night? *

Where will your pet NOT be allowed in the house? *

How many hours a day will your pet be left alone? *

How do you plan to housetrain your dog? *

How do you plan to exercise your dog? *

Under what conditions would you NOT keep your new pet? *

Tell us more about yourself

Do you travel frequently? *

Will your pet go with you when you travel? *

How will your pet be cared for when you are out of town? *

Briefly describe your lifestyle *

How much do you think pet care costs per year? *

Have you ever euthanized a pet? *

Do you have a friend or relative who would care for your pet if you became incapacitated for an extended period of time? *

Tell us about your veterinarian

Name of your current OR PREVIOUS veterinarian *

Clinic Name for your Veterinarian *

Address for your Veterinarian *

Address Line 1

City

State

Zip Code

Phone Number for Veterinarian *

May Rescue Revolution contact your veterinarian? *

Tell us about your other pets

Current number of pets in your household *

Please list pets you have owned in the past 10 years to present

First Pet:

Pet Name and Breed *

Type of pet *

Dog
Cat
Other
N/A

Age of pet *

Sex of pet *

Male
Female
N/A

What type of heartworm preventative is/was your pet on? *

Pet spayed / neutered? *

Do you still own this pet? *

Second Pet:

Pet Name and Breed *

Type of pet *

Dog
Cat
Other
N/A

Age of pet *

Sex of pet *

Male
Female
N/A

What type of heartworm preventative is/was your pet on? *

Pet spayed / neutered? *

Do you still own this pet? *

Third Pet:

Pet Name and Breed *

Type of pet *

Dog
Cat
Other
N/A

Age of pet *

Sex of pet *

Male
Female
N/A

What type of heartworm preventative is/was your pet on? *

Pet spayed / neutered? *

Do you still own this pet? *

Fourth Pet:

Pet Name and Breed *

Type of pet *

Dog
Cat
Other
N/A

Age of pet *

Sex of pet *

Male
Female
N/A

What type of heartworm preventative is/was your pet on? *

Pet spayed / neutered? *

Do you still own this pet? *

Fifth Pet:

Pet Name and Breed *

Type of pet *

Dog
Cat
Other
N/A

Age of pet *

Sex of pet *

Male
Female
N/A

What type of heartworm preventative is/was your pet on? *

Pet spayed / neutered? *

Do you still own this pet? *

Please provide two personal references

Name *

First

Last

Phone *

Relationship *

Name *

First

Last

Phone *

Relationship *

Almost There!

I understand that pet ownership is a commitment for life, and bringing a pet into my family means he/she will be treated like a family member *

I understand that pets cost money and must see a veterinarian at least yearly and be on heartworm preventive monthly *

I understand that my new pet will be be spayed/neutered before the adoption is final. This is included in the $150 adoption fee *

I understand that adoption may require a home check and/or delivery of the pet. I consent to this in the event my application is approved *

I understand that I MUST return my pet to Rescue Revolution of Mississippi should I not be able to keep him/her *

I understand that Rescue Revolution tries to place each pet with the best home fit for the pet. I understand that Rescue Revolution may refuse adoption to anyone for any reason *

I understand that fostering a dog or cat for Rescue Revolution of MS does not mean that I am automatically approved to adopt. I understand that I will have to go through the same adoption application process and meet the same criteria as any other applicant and pay the $150 adoption fee if approved *

Yes
No
Other

I acknowledge that by my electronic signature below, I do hereby release, discharge and agree not to hold Rescue Revolution of Mississippi, it's directors, officers and volunteers liable for any and all claims, demands, costs, loss and damage which may result, directly or indirectly from adopting an animal from our organization *

Your Name *

By typing your name above and choosing "I ACCEPT" you state above information is true and correct and that you understand consents and accept them. This is a legally binding electronic signature. *

I ACCEPT
I DECLINE

Date completed *