Adoption Application

What dog are you applying for? *

Is this application toFosterAdopt

TELL US ABOUT YOU AND YOUR FAMILY

Name

Age *

Address *

City *

Zip code *

What large city is nearest to your home? *

Home Phone *

Cell Phone *

Occupation *

Email Address *

How long at this Job? *

Years at current residence? *

CO-APPLICANT

Name

Age *

Home Phone *

Cell Phone *

Occupation *

Email Address *

Years at current residence? *

How long at this Job? *

ABOUT YOUR HOME

Do you rent or own? *

Do you have permission to have a dog?YesNo

Landlord’s Name *

Landlord’s Phone *

Do you have a fully enclosed yard?YesNo

Type of fencing *

Height of current fence *

Do you have a swimming pool?

Is the pool, pond, hot tub, lake or river securely fenced off from the rest of the yard?

Is your home air conditioned?

Where the dog be kept during day?

Where the dog be kept during night?

GENERAL QUESTIONS

Distance you are willing to travel to adopt?

Does your car have air conditioning?

Expectations for a Rescued dog

Why do you want to adopt a dog?

What age dog are you willing to accept?

Must the dog you adopt be good with children?

Must the dog get along with other dogs?

Are you willing to accept a dog needing additional care?

What level of care are you comfortable providing (daily medication, food, etc.)?

Please list all members in your household other than applicant and co-applicant?

Name

Age

Name

Age

Name

Age

Name

Age

Name

Age

Will children (other than your own if applicable), be visiting your home?YesNo

List age and frequency

Willing to supervise dog all times with children under age of 10?

Who will be responsible for caring for your dog?

What 5 words best describe your family?

Anyone in your household allergic to dogs?

All members of household in favor of adopting a dog?

Please describe any changes you expect in your household in the next few years: e.g. new children, job changes, moving, etc.

How soon will you be ready to adopt a dog?

Are any family members at home during the daytime?

Are you involved in any pet store, commercial dog breeding operation, or buying dogs for resale?

Have you ever been convicted of cruelty to animals?

Have you ever suspended from a pure-bred dog association?

Please list current & past pet(s) that have lived in your household in the past 5 years

Name

Age

Type

Gender

Spayed/Neutered OneYesNo

Living Status OneAliveDeceased

Name

Age

Type

Gender

Spayed/Neutered OneYesNo

Living Status OneAliveDeceased

Age

Type

Gender

Spayed/Neutered OneYesNo

Living Status OneAliveDeceased

Have you ever given a pet to a rescue shelter organization or animal shelter?

Under what circumstances you gave a pet to a rescue shelter organization or animal shelter

Do all your pets receive regular veterinary care?

Are they up-to-date on vaccinations?

Are you presently working with another rescue?

Please notify us immediately if you adopt a dog

Do you use heart-worm preventative?

What kind of heart worm preventative you use?

Do all of your current pets get along with other animals?

If no, please explain?

Have you ever owned a dog that has bitten someone?

If yes, please explain?

Pet Care Philosophy

What type of behavior in a dog would make you not want to adopt him or her?

How will you correct behavior problems?

Jumping up on people

When someone comes over and knocks or rings the doorbell?

Are you familiar with common health problems?

Your Plans

Including weekly food costs and routine vet care, how much do you anticipate spending per year?

What would you consider reasonable vet care costs under extraordinary circumstances, such as illness, surgery, etc.?

Do you intend to get, or do you have pet insurance?

Who will care for the dog during vacations or overnight trips?

Can someone in the house provide dailycare when primary caregiver is away?

Do you have plan to provide care if you have to leave town suddenly?

What do you feel is the proper use of crates or cages?

How many hour per 24 hour day do you anticipate that your dog will be in a crate or cage?

How will you exercise them?

What will you feed them?

What will their eating schedule be?

Who will let them out during the work day?

How much do expect to spend on food per week?

Agreements / Understandings

Can all household members travel to the rescue group to meet the prospective dog?

Are you willing to take responsibility for the dog for its lifetime?

Are you good to do a Facetime call before or after an adoption is completed?

What circumstances justify you giving up your dog?

All age appropriate dogs adopted from us will be spayed/neutered before placement. any questions about this policy?

Do you agree to return/surrender the dog back to us if you not fulfill the requirements of the adoption or the placement not work out?

Veterinarian Reference

Please tell us whose name the records are under

Name

Office Phone

Address

Office Fax

City/State/Zip

Email Address

$10 Donation is required for Application

There is an adoption fee beginning at $575 which includes all vetting, vaccines, spay, neuter and microchip