Adoption Application

Please fill out the following adoption application completely. The adoption process is designed to match the right dog with the right family. Since looks are not all that makes a dog special, we concentrate on personality and compatibility with their new forever home. Please remember that not all Jack Russell Terriers are the same.

Please contact Jacks Galore if you have any questions regarding the adoption fee for these wonderful terriers.

Do you own or rent your home?  
Do you have your landlord's permission to own a dog?    
Do you have a securely fenced yard?  
Are there any children?  
Would you consider adopting a mix?  
Would you consider adopting a dog with some minor physical impairment?  
Veterinarian Information
Even if your dog has passed, we would appreciate your last vet's information below.
Do you have a regular veterinarian?     (If "No", skip this section)
References and Comments