ALFA Dog Adoption Application

• Please provide complete and detailed information as requested in each section.

• Please notify your vet, landlord and references that ALFA Rescue will be contacting them and authorize them to release information relating to your foster/adoption application.

• Upon approval of your application, a meet and greet will be scheduled as part of our best effort to make the relationship a success.

• A home visit is the final part of this application. A member or members of the ALFA Rescue team will contact you to arrange the visit.

Our adoptable dogs: All pets available for adoption (over the age of 8 months) are current on all vaccinations, have been spayed/neutered and are micro-chipped. If for any reason the dog is not fixed, we will not finalize the adoption until the pet has been altered. If less than 8 months of age, ALFA Rescue will bring pet current on vaccinations and will spay/neuter the pet. Any and all information regarding the health and personality of each pet will be disclosed (to the best of our knowledge) before the adoption is finalized. All health records are available for viewing (upon request).

This questionnaire is designed to help ALFA Rescue and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. ALFA Rescue reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!

Name of the dog you are interested in: *

Your full name: *

Your age: *

Street Address: *

City, State, Zip *

Home Phone:

Area Code Phone Number

Work Phone:

Area Code Phone Number

Cell Phone: *

Area Code Phone Number

Best time to call:

E-mail:

Employer and phone number

Are all members of your household in agreement with this adoption? *

Yes No Don't Know

Who will be the pet's primary caregiver? *

Do you live in a *

House Apartment Condo Mobile Home

Do you own or rent? *

Own Rent

If you rent, does your landlord allow dogs?

Yes No

If rent, provide name of landlord *

If rent, provide cell-phone number of landlord: *

If rent, provide email of landlord:

Are there any restrictions from your landlord or subdivision? *

Number of pets Size or weight restrictions Breed restrictions None

Is your yard secure and fully fenced *

Yes No

Height and type of fence

Do you have any of the following?

Underground fence Kennel Dog Run

How many adults are in your household? *

How many children are in your household? *

If children, what are their ages?

Have your children been around animals before?

Yes No

Does anyone in your home have allergies to dogs or have asthma? *

Yes No

Does everyone in the home agree on adopting a dog? *

Yes No

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sexe, UTD Vaccines, Heartworm, Living/Deceased) *

Have you ever surrendered or given pet away? please explain the circumstances *

Have you adopted from an animal group before?

Yes No

If yes, what group?

Have you ever given up a pet?

Yes No

If yes, what were the circumstances?

Please provide the name and phone number of your current and/or previous veterinarian or clinic: *

(Providing this information means you are allowing ALFA Rescue to contact your vet. Please contact your vet and authorize them to release information to ALFA Rescue)

What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato) *

Desired age: Puppy/kitten (under 8 mos), Young (8 mos – 2 yrs) Adult (2 – 7 years) or Senior (7 + years) *

Desired Size: Small (less than 20 lbs) Med (20 – 59 lbs) Large (60 – 99 lbs) X-large (100 + lbs) *

Do you have a breed preference? *

Yes No

If yes please explain

Are you aware of crate training? *

Yes No

Have you ever house-broken a dog or puppy before? *

Yes No

If the dog has an "accident" in your home, what type of correction do you plan to use? *

How many hours each day will your new pet be home alone? *

Where will your new pet sleep at night? *

How will you supervise the dog's outdoor activity? *

Where will your new dog stay when nobody is home? *

What length of time will you allow your new pet to adjust to his new home? *

Are you willing to work through your new pet's issues, if any? *

Yes No

Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior? *

Yes No

Do you understand that a dog can be an 18 year commitment, and can cost $300 - $500 per year to care for? *

Yes No

Do you plan to take an obedience class with your dog? *

Yes No Not sure

If yes, where?

Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for? *

Yes No

What circumstances would lead you to give up your new dog? *

If you had to give up your dog, what would you do with him/her? *

How did you find out about ALFA Rescue?

Adoptapet.com Petfinder.com Facebook Friend/Family Member Other website PetSmart

References: It's helpful to provide references that can speak to your experience with (or ownership of) pets.

Please provide 3 nonrelated references that you know over 5 years.

#1 referece *

#2 referece *

#3 referece *

I certify that the above information is correct, and I understand that the information will be verified.

I acknowledge that all of the information I have given is true and complete. Any misrepresentation of information authorizes ALFA Rescue to deny my application.

I agree to have ALFA RESCUE complete reference call checks and conduct a home visit inspection to be able to approve my adoption application.

I understand that I assume full responsibility for the welfare of this pet from the date of adoption.

I accept full responsibility for the dog(s) actions at all times, and release ALFA RESCUE from any liabilities or damages that may be incurred because of adopting such dog(s).

Applicant Signature and Date *

Clear

A Love For Animals Rescue Dog Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information