NARR Pre Adoption Form

Sumitting this application does not mean you are commiting to a dog, nor does it guarantee you will get that dog. It is simply a tool we use to help both you and us identify a good potential match for your family and lifestyle.

A successful adoption depends on selecting the right dog for your household and a good understanding of the dog's needs and care requirements. Please help us with this process by answering the following questions fully & completely. THANK YOU!
Applicant's Name*
First & Last Name
Name of the dog you want to adopt*
Address*

Street Address

Street Address Line 2

TownPostcode

County
Adopter's E-mail*
Mobile Number*
Landline Number*

STD CodePhone Number
Names and ages of all adults of your home *
Names and ages of all children of your home *
Do you currently have any pets?*

YesNo
If you currently have pets, please list them below.
Previous dog experience
Are your current pets spayed/neutered?

YesNoWill be within the next 30 days, appointment has been scheduled. (We will call your vet to verify this.)
If your current pets are not spayed/neutered please explain why below.*
Current vet name and address *
Vet name, address & phone number
Are you planning to move in the near future?*

YesNo
If moving soon please advise new town/city?
When will you be ready to adopt this dog?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Are you in contact with any other rescues or shelters about a specific dog?*

Yes, application is pendingYes, just an email inquiry, no app yetNo, but I am looking at several dogs onlineNo, I am only interested in this particular dog
Are you going to meet another dog?*

YesNo
If so, when?
Is anyone in your home allergic to dogs?*

YesNo
Does anyone in your home fear dogs?*

YesNo
Does anyone in your home smoke?*

YesNo
I/We live in a*

HouseBungalowFlatOther
Do you rent or own this property?*

RentOwn
Tenants, have you contacted your landlord to find out if there's any restrictions on having a dog?

YesNoNot yet, but I willIt's written in our lease
If you rent, you must show us a written letter from your landlord or a copy of the section of your lease agreement stating that you are allowed to have dogs and showing any limitations.
Do you have a garden? Roughly what size?*

Small gardenMedium gardenLarge gardenOther
If fenced how high?

Below 4ft4' high5' high6' highOther
Occupation
Hours worked*

Full timePart timeOne applicant is home/works from homeWe work different shifts
If you both work full time, how many hours per day are you away?
How many hours per day will this dog be alone? Please explain.*
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Children don't know yet.
We will be speaking to all adult residents to confirm everyone is aware of this application process and wants to have a dog added to the family. Please do not submit this application if you are "trying to talk someone into" adopting this dog or think "once they meet the dog, they will want one" or "I'm getting this dog as a surprise birthday present for them." In those scenarios, you are welcome to email us to discuss the dog, but we would like all adults in the home to be involved in that email discussion.
Are you aware of the costs involved in keeping a dog per annum (for things like insurance, vet fees, food, toys, bedding, other supplies, training, pet sitting, etc)? *
What activity/energy level do you prefer?*

Very activeDaily jogging partner would be excellentMedium energy, plays a bit, walks a bitLow energy, walks slowly, couch potatoOther
Please take time to think, be honest with yourself and us when answering this question. What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the dog?*

HousebreakingChewingJumpingPulling on leash during walksObedience trainingFear of menFear of womenFear of childrenMouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training)GrowlingBarkingRough play with my dogHigh activity levelFood/toy aggression/not willing to share with other dogsFood/toy aggression with peopleWhining/cryingBlindnessLimited SightDeafnessSeparation AnxietyDiabetesSpecial DietLong Term MedicationIncontinence / Leaking UrineTaking classes with the dogGets stressed/carsick when riding in vehicleHeart conditionSkin allergiesFood allergiesTrimming nailsOther
What would cause you to return a dog?*
What do you feel is a reasonable amount of time for a dog to adjust to life with you/your family?*
How do you plan to integrate this dog into your family?*
What would you do if you discovered after adoption (at any time during the life of the dog) if your vet diagnosed an expensive health condition?*
Do you plan to get pet health insurance?*

YesNoI wasn't aware this was available. I will look into it.
How long have you been looking for a dog?*
Do you plan to take formal obedience classes?*

YesNo
Additional reference (if desired)
Do you have any additional comments, questions or concerns? Anything else you would like us to know to help match you up to a dog?*
I understand that completing this application does not guarantee I will be allowed to adopt a dog, and that the application is a tool to help Noah's Ark Romanian Rescue determine whether a particular dog is a good fit.. I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the adopted dog from my possession. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from Noah's Ark Romanian Rescue to contact my vet for a reference and also agree to allowing a home visit prior to adopting this dog. If I am approved to adopt a dog, I agree to pay a non-refundable adoption fee and hand sign an adoption contract at the time of adoption.
Please read the above, check this box, sign, and click Submit.*

I/We have read and understand all of the above.
Applicant's Signature*
Signature date*
After you submit this form, we will review the submission and contact you as soon as we can. Feel free to email us with any questions:

noahsarkrr@gmail.com

Noah's Ark Romanian Rescue reserves the right to reject any application based on information obtained during this screening process. Please understand that our primary goal is the health, happiness, and safety of our rescued dogs.
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