Atlas Animal Rescue Adoption Application

1
Are you ready to adopt now?* This field is required.If not, please come back when you are ready!
YESNO
2
Full name* This field is required.
First Name
Last Name
3
Email address* This field is required.
example@example.com
4
Phone Number* This field is required.
Area Code
Phone Number
5
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Type of home you live in?* This field is required.(Please pick one)
House
Apartment
Condo
Other
7
Do you?* This field is required.(Please pick one)
Own
Rent
Live with parents/relatives
Other
8
What is your age range?* This field is required.
18+
20-30
30-40
40-50
50-60
60+
9
I am looking to adopt a rescue animal because?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
10
How did you hear about Atlas Animal Rescue and our adoption program?* This field is required.
11
Is there a certain dog you are interested in?* This field is required.
12
Are you able to make a long term commitment to care for your new adopted pet for its entire lifespan?`* This field is required.
YESNO
13
If any, please list all the other adult occupants in your home and their relationship to you.* This field is required.
14
If any, please list all the names and ages of any children in your household.* This field is required.
15
Does anyone in your family have a known allergy to the animal you wish to adopt?* This field is required.
16
If any, please list the type, breed, age, and sex, of any current pets living in your home.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
17
Are these pets up to date on vaccines?* This field is required.
YESNO
18
Are these pets spayed/neutered?* This field is required.
YESNO
19
Do you have a completely fenced in yard?* This field is required.
YESNO
20
Do you have a pool?* This field is required.
YESNO
21
Is your entire family on board with this process 100%?* This field is required.
YESNO
22
How many hours a day would the dog be alone?* This field is required.
23
Where will the dog spend the day? Will they have access to outside?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
24
Where will the dog stay when left home alone?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
25
What would you do if your dog escaped from your home?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
26
Have you ever had a pet that had behavioral issues?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
27
Where will the dog stay if you go on vacation?* This field is required.
28
Are you flexible?* This field is required.Sometimes certain dogs we rescue get a higher number of adoption applications, would you be flexible on adopting a different dog if your first choice was adopted?
29
Will you be able to cover the adoption cost?* This field is required.Our adoption fees for dogs range from $350-800 depending on local vs. international rescue. Our international rescues (China, etc) are a bit more costly due to transport cost , etc. Would you be able to cover the adoption cost for the pet you are hoping for? Our cat adoption fee is $125.
30
What are your exercise plans for the dog?* This field is required.
31
If your dog had a medical emergency, would you be able to cover the cost to help them?* This field is required.
32
Are you prepared to have a new pet in the home?* This field is required.With any new pet you bring into your home you will have an adjustment period. Getting them on your sleep schedule, potty training, etc, are you prepared to give them that time and patience?
33
What would you do if the dog bit you?* This field is required.Although we thoroughly assess each dogs behavior prior to adopting them out, IF something were to lead to the dog biting you, what would you do?
34
If you became sick injured or ill who would take care of the dog?* This field is required.Life unfortunate happens fast and we don't always see where its headed, if you were in the hospital for a prolonged period of time, who would take care of the dog?
35
What would be your breaking point to surrender a dog?* This field is required.Many of our rescues have been through hell and back and are not perfect, they need love, understanding, and patience to be a dog once again. What would be your breaking point to surrendering a dog?
36
Home Photos* This field is required.After your application is sent, please then email 4-5 clear photos of your home. Be sure to include *both* inside where the dog will live, as well as the yard, or patio areas. You can email them to info@atlasanimalrescue.org and we can proceed from there. Please check YES that you understand and can complete this last step.
YESNO
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