Adoption Application

PLEASE NOTE: All of our dogs are in private foster homes so you must be approved before you are able to meet them. And once approved, you must be willing to go to travel to that area to facilitate the adoption.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long at this address?:*
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Name and Address of Employer:
Work Phone Number

Area CodePhone Number
Up until what time of night can we contact you via phone?*
E-mail*
Are you able to afford the adoption fee of $350 for dogs or $400 for a puppy?*

YesNo
What is your timing for wanting to adopt?*

ImmediatelyNear futureGeneral InquiryJust want to be approved for right dog in future
How were you referred to The Last Resort Rescue?*
Are you planning on moving in the near future?*

YesNo
If yes, what are your plans for your pets if you move?
Birth Date*

MonthDayYear
Do you own your own home?*

YesNo
If no, name and phone # of landlord:If you rent, you must provide Landlord's contact information or a copy of the section of your lease stating that you are allowed to have this type of animal and showing any limitations.If you live in a condo or townhome, you must show us written proof that you are allowed to have this type of animal there and show any restrictions.If you live in a neighborhood with an HOA, you must check your covenants to determine if there are breed restrictions or if the number of pets is limited. Note...this trumphs county law.**Please also check how many pets your county law permits.** WE WILL VERIFY THIS INFO !
Type of Dwelling:*
How many hours will your new pet be left alone during the average day?*
Do you plan to use a crate?*

YesNo
If so, how many hours will your new pet be in the crate?
If no crate, where will your dog stay during the day?
Name and current AGE of all occupants in the household:*
If no children, will small children be visiting frequently?*

YesNo
Are any members of your household allergic to animals?*

YesNo
If yes, please describe:
Who will have chief responsibility for the care of your new pet?*
Over the past 5 years, how many pets have you owned? (Include current pets)*
MUST List each individually including breed, age, still living with you? (if not, why?)
Have you ever lost, given away or rehomed a pet?*

YesNo
If yes, please explain:
Have you and your spouse (if applicable) ever owned a dog together?*

YesNoN/A
If yes, when?
If you currently own a dog, how does he/she react to new dogs? Any behavioral issues?
Are your present pets up-to-date on their annual vaccines?*

YesNoN/A
If no, please explain:
Are your present pets spayed or neutered?*

YesNoN/A
If no, please explain.
Were your previous pets spayed or neutered?*

YesNoN/A
If no, please explain.
How much are you financially prepared to spend for routine/emergency medical care, licensing, etc?*
What plans do you have for your new pet when you are on vacation?*
How do you plan on exercising your dog?*
Which dog(s) on our website are you interested in? (applicants interested in dogs we have currently listed will be contacted first)*
Age of dog you would consider adopting: (check all that apply)*

2-12 months1-5 yearsSeniorSpecial Needs
Energy Level of dog you would consider adopting: (check all that apply)*

LowModerateActive
Size of dog you would consider adopting: (check all that apply)*

Under 20lbs20 - 50lbs50 - 100lbsOver 100lbs
Sex of dog you would consider adopting:

MaleFemaleEither
If considering a puppy, are you prepared to deal with and have you thought about the following issues: Housetraining, Chewing, Barking, Crying at night, High energy level, Nipping, Socializing, Training (we strongly suggest basic puppy classes for all puppies we adopt out)*

YesNoN/A
Who is your current or most recent veterinarian? Please provide their NAME and PHONE NUMBER: PLEASE MAKE SURE YOU CALL YOUR VET TO GIVE PERMISSION TO RELEASE INFORMATION AS MANY WILL NOT GIVE US A REFERENCE W/OUT YOUR CALL, AND WE WILL NOT BE ABLE TO PROCESS YOUR APPLICATION.*
Will you provide your dog with monthly flea/tick prevention?*

YesNo
Will you provide your dog with monthly heartworm prevention?

YesNo
Are you prepared to and financially able to provide your dog with an annual veterinary exam, annual vaccinations, and any necessary veterinary care as needed?*

YesNo
What brand of dog food do you plan on feeding your new pet? (Please read the attachment that you will receive after you submit this application)*
How would you deal with any behavioral issues that may come up? (What is your style/method of training?)*
What type of behavioral issues are you NOT willing to work with? (Check all that apply)*

HousetrainingNippingFood AggressionShy/Scared DogsDestructive BehaviorChewingDiggingChasing Cars/BikesExcessive BarkingOtherNone of the Above
If you listed other, please explain:
At what point would you be willing to take your dog to a professional trainer? (Your vet is NOT a trainer)*
Is your entire immediate family in agreement with the decision to bring a new pet into your home?*

YesNo
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 10-15 years (average life span)?*

YesNo
Have you or any member of your household ever been charged with a violent crime? including and especially animal cruelty?*

YesNo
If yes, please describe:
Have you ever adopted or tried to adopt a pet before with another group? If so, please list their info below*

YesNo
Rescue Information

Name of RescueContact Name
Rescue's Phone Number

Area CodePhone Number
Are you currently applying to other rescues? (we ask this because we are a volunteer run organization and applicants who are currently applying just to our rescue will be screened first)*

YesNo
Why are you choosing to adopt vs. buying from a pet store or breeder?*
Where will your pet spend most of his/her time?*
If other, please explain:
If your dog will spend time outside unsupervised, describe any shelter available.
Describe your fence:*
If no fence, would you be willing to install some type of fence for the security of the dog?

YesNo
Where will your dog eat?*
Where will your dog sleep? ( BE SPECIFIC) *
Would you consider volunteering for our organization ?

YesNot at this time
If yes, which of the following areas interest you?

Temporary Foster CarePersonal interviewing of adoption candidatesFundraisingTransportingHome VIisitsRepresenting us at an Adoption EventOther
If other, please specify:
How far are you willing to travel to meet and adopt your dog once approved?
Please provide 3 personal references (ONLY 1 can be a relative) that can testify to your responsibility and ability to care for your animals. ( YOUR VET IS NOT A REFERENCE!!) This is required or your application cannot be approved. PLEASE BE AWARE: If your references are not easily reachable or do not reply in a timely manner, it will delay your application. If multiple references do not reply, your application will be filed on HOLD. Please choose your references carefully and be sure to list the correct contact numbers.
Reference #1*
First and Last Name & Relationship to Self
Reference # 1 Phone Number*

Area CodePhone Number
Reference #2*
First and Last Name & Relationship to Self
Reference #2 Phone Number*

Area CodePhone Number
Reference #3*
First and Last Name & Relationship to Self
Reference # 3 Phone Number*

Area CodePhone Number
If there is anything else you think we should know, please note it here.
Please remember, we are all volunteers and it may take approximately a week or more for us to get back to you.
Once we have received your application, you will receive an email confirmation within 24 hours.
Thank you so much for wanting to rescue a dog!!
Should be Empty:

Please remember, we are all volunteers and it may take approximately a week or more for us to get back to you.

Once we have received your application, you will receive an email confirmation within 24 hours.

Thank you so much for wanting to rescue a dog!!