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Dog Adoption Application

Cat Adoption Application

    
Dog Adoption Application

Requested Information
Date:
First Name:
Last Name:
Adopter's Age:
Spouse's First Name (if applicable):
Spouse's Last Name (if applicable):
Spouse's Age (if applicable):
Address (Street, City, Region, Postal/Zip, Country):
Phone, Home:
Phone, Cell:
Email:
If you do not currently own a pet, keep in mind that you are applying to adopt one and will need to secure a vet before placement.
Vet's Name:
Vet's Address (Street, City, Region, Postal/Zip, Country):
Vet's Phone:

Personal Reference #1
First Name:
Last Name:
Phone #:

Personal Reference #2
First Name:
Last Name:
Phone #:

Requested Information Section 2
Your Employer:
Ever house trained a dog successfully
Are you applying for a particular dog? If so, which one?
If not, what kind of dog do you want and why? Be as specific as possible.
Number of Adults in Home?
Number of Children in Home?
Childrens Ages:
How long have you lived at your current address?
If less than 5 years, please list previous addresses
Do you own or rent?
If rent, please provide landlord's name, address, phone:
In what type of home do you live?
What type of environment?
Does your home have a basement?
Does your home have a yard?
To feed, vaccinate, license & provide medical care for this animal, what do you anticipate spending yearly? Consider the following estimated costs: One vet office visit: $35-$50 Annual shots: $20-$25 each X 3 shots/year = $ Plus food, grooming, bed, medications, neuter/spay,sick dog visits, license, etc.
Can you afford the care?
If you adopt a dog and discovered a costly medical problem ($1000+), that is correctable, what would you do?
Are you willing and prepared to deal with potential medial problems and/or special needs, should they arrive, in the future?
Which member(s) of the household will feed and care for this animal?
Plan for crate use - check all applicable answers
Have you considered the full ramifications of caring for a dog for its entire life- including illness and old age?
Check all traits you are looking for in a dog:
Do you prefer a male or female dog?
When you are away from your home for a few hours, where will the dog stay while you are gone?
How many hours a day will this animal be alone?
When you go away for a few days, who will care for this animal?
Where in the house will your dog be kept most of the time?
Where will your dog sleep at night?
If necessary, will you take your dog to an obedience class?
Have you previously owned a dog?
If so, what kind(s)... Breed - Sec - Age - Sprayed/Neutered - Present Location:
What discipline will you use?
Are you familiar with the "pack" mentality of dogs?
What would your reaction be if you came home to pee/poop in the house?
Do you have:
What age rande are you looking for?
What weight preference are you looking for?
Would you consider a dog with special needs?
Would you consider adopting a bonded pair?
Have you ever given up a dog, or taken a pet of yours to a shelter?
Do you have other pets? If so, list: breed, age, sex, size of each:
Are all other pets current vaccinations?
Are your animals on heartworm preventative?
How long would you allow an adopted dog to adjust to you, your home and your current pets (if you have any) and what would you do after that period of time, if the dog has still not adjusted?
List any humane societies, organizations, breed or training clubs you are associated with.
What do you know about rescues?
Why do you want to adopt a dog from a rescue?
We attempt to provide you with an honest evaluation of the temperament of any dog we have to place. Do you realize that often times the complete history of the animal may not be known, and you may encounter some behavioral issues? Are you willing to work with us on correcting those problems?
How much research have you done about the breed?
Please list any comments or questions you have.

I certify that the information provided on this form is true and correct. I am also financially and physically able to care for the animal. I understand that proper food and veterinarian care may be costly, and I am able to meet these requirements. Submitting this application denotes information provided is true and correct. If, upon a home inspection, we find that information contained in this application is false, we retain the right to turn down your request or remove the animal from your premises without a refund of monies paid. If you decide that you cannot take care of the dog/want the dog, money will not be refunded. Submitting this application denotes acceptance of terms.
SIGNATURE OF POTENTIAL ADOPTER
DATE
SIGNATURE OF RESCUE REPRESENTATIVE
DATE