To adopt this animal from St. Francis, you must first fill out this Adoption Agreement form and submit it. The form will be carefully reviewed by an adoption counsellor. We try to get applications reviewed as quickly as possible. If we have problems contacting your references, this will delay the process. Most disapprovals result either from a negative veterinary reference, a "no pets" policy by landlords, or a difference in philosophy regarding the treatment of animals. St. Francis Society is a privately owned, all volunteer organization. We have strict guidelines for adoption approval and our volunteers have the right to refuse adoption applicants based on their own judgment.

Once an application is approved, the adopter is notified and can arrange to pick up their new pet. There are certain items that you must have before we will release the pet. A volunteer will be happy to assist you with shopping for your new friend before leaving our Adoption Center. You will also receive a copy of the pets health records and a packet of information put together especially for you and your new pet by one of our volunteers.

You Are Applying to Adopt...

Jelly Roll
Breed:Basenji (Mix)
Color:Brindle (Brown)
Age:4 yrs 4 months
Weight:45 lbs
  • My story: Hi, my name is Jelly Roll, I am a sweet guy looking for a forever home. I have the corkscrew tail of a basenji, and the beautiful brindle coat of a pit bull terrier. I am a quick learner. I can sit, shake and rollover, I walk well on a leash, I am housebroken and I never chew on anything. I like to groom myself, I lick every spot I can reach, so I stay nice and clean. I am two years old and have been in foster care for over a year. Living with my foster family is great; but, I am ready for a home of my own. Could I be one of your family members, I promise to give you lots of love and attention!!! He is very affectionate and very active but also likes in-your-face quiet/calm time. Fenced yard is preferred. If interested in adopting or meeting, first step is to complete the adoption inquiry form at

    Special Needs: Best in single dog home or with another large dog

    Good with Cats: Yes  |   Good with Dogs: Yes  |   Good with Children: Yes

Adoption Agreement form

Please indicate whether you agree to the following terms:

I will provide this animal with safe and pleasant surroundings, quality care, food and medical services when needed. This includes good grooming and keeping this pet free of all parasites. I agree
I will arrange for the care of this animal (pet sitter, boarding, etc.) if necessary during my absences (vacation, etc.). I agree
Cat/Kitten: I will not allow this cat/kitten to be declawed (if not already). I agree
Dog/Puppy: I will not allow this dog/puppy to roam freely. I will obey leash laws. I agree
I will maintain this dog/puppy on heartworm preventative medicine. I agree
It is our responsibility to find permanent loving homes for all animals under our care. We will be happy to work with you to choose an animal that suits your wants and lifestyle; however we DO have adoption guidelines and may deny an adoption we feel is unsuitable. I agree
St. Francis Society has the right to confiscate the adopted animal if the animal is not being cared for properly (i.e. lack of food/water shelter, roaming free, or any form of neglect). We also have the right to confiscate the animal if we discover that false information was provided on this form or during the adoption interview. I agree
A minimum donation is required for adoption. Feline: $60 ($120 for pure mix/breeds) - Canine: $125-$200 depending on size ($300 and up for pure breeds) I agree
The adopter hereby agrees to communicate with St. Francis during the new owner/pet adjustment period to ensure that a mutually satisfactory owner/pet relationship is established. I agree

Information About Pet You Want to Adopt

Please give your reason for wanting a new pet
Is the pet for you and/or your family? Yes No

Driver's License Information

Drivers license #
Drivers license state issued

Employment Information

Do you work outside of the home? Yes No
Employer's name
Employer's address
Employer's phone number
How many hours per day are you away from your home for work?

General Questions

What are your plans to care for this animal if you have to leave town on a planned vacation or unexpectedly in the case of a hurricane?
Where will this animal be kept? Inside Outside
Do you have children currently living in your household? Yes No
Have you owned other animals? Yes No
Are the other animals in your household spayed or neutered? Yes No
Who is your current veterinarian?
Clinic Name & Location

Your Housing

Do you rent or own? Rent Own
DOG ADOPTIONS ONLY: Do you have a fenced-in yard? Yes No
I certify that the information provided is complete and correct and I understand that if it is discovered that I have given any untrue information. St. Francis Society has the right to confiscate the animal without a refund of my adoption fee.