• Please enter a number from 1 to 50.
  • Please enter a number from 0 to 24.
  • NameBreedAgeNeutered?Time in your careUp to Date Vaccinations 
  • NamePhone NumberYears known 
  • By signing this form, l/we acknowledge that all information on this form is true and correct. I/we understand that any misrepresentation of fact may result in Darbster Foundation refusing adoption privileges to me/us. If my/our request for adoption is approved and later Darbster Foundation discovers the above information is not true or correct, Darbster Foundation reserves the right to remove the adopted cat from my home/farm. If you have exhausted all reasonable efforts to keep your pet, Darbster Foundation accepts the return of any animal adopted from our facility. Adoption returns must be scheduled in advance and are accepted by appointment only. Guardians who wish to return their adopted animal should call 603-635-4495 or email to schedule an appointment. Note- there will be an intake fee of $75 if the dog is returned after 14 days from the original adoption date.
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.