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Dog Adoption Application Form

Welcome to Good Samaritan Pet Center Adoption Program. The following information is required so that we can assist you in the selection of a new dog. This form and a consultation with a Good Samaritan Representative are designed to help you find the dog most compatible with your lifestyle.
(NOTE: All information is required. If you leave any fields blank, it will delay the processing of your application.)

If you would prefer to download this application, click here for a PDF version of the dog adoption application.

In order to be considered as an adopter you must:

*Completion of this form does not guarantee adoption of a Good Samaritan dog.