Adoption Application Powder’s Pals Rescue

Powder’s Pals Rescue

Telephone 214-901-0906 powderspalsrescue@gmail.com
Dog's name
Please fill out this form completely.
Applicant's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number
Please enter a valid phone number.
Phone Number
Please enter a valid phone number.
Alternate Number
Please enter a valid phone number.
Email
example@example.com
How did you hear about us:

PetfinderRescueme.orgFacebookOther
Is this dog for yourself or someone else?
Are you aware adopting a dog is a commitment of up to 18 years:

yesno
Do you live in a house, apartment or condo/townhouse?

houseapartmentcondo/townhomeOther
Do you own/rent your home? If you rent, are you willing to provide written proof stating ability to have a pet?

OwnRentyes, I can provide proofOther
Do you live alone or have others living in your apartment/house?
If you have other people living with you, who?
Ages of all people living in the household?
Do you or anyone who will be living with a new pet have any allergies to animals?

yesno
If yes, please explain
Do you currently own any pets?

yesno
What species?

dogcatOther
How many?
Are your pets friendly to other dogs?

yesno
What breed dog do you currently own?
Are your pets (dogs/cats) spayed/neutered?

yesnoOther
What happened to your previous pets (if any)?
Have you ever rehomed one of your pets?

yesno
If yes, what was the reason?
Where will the dog stay when you are not home?
If you had to move, would you make sure the new place accepts your dog/pets?

yesno
Are you willing and committed to take full responsibility for the medical care of this dog (shots are u to date, annual vet visits, emergency vet if needed, medication if needed, appropriate recommended diet, etc....)?

yesno
Are you willing to accept full responsibility for training the dog it he/she has some behavioral issues (housebreaking, chewing, leash training, biting, etc....)?

yesno
Are you aware that certain breeds require regular grooming and may require additional costs to take care?

yesno
Are you willing to give a rescue dog adequate time to adjust to his/her new home (could take months)?

yesno
Please let us know who your veterinarian is and where he/she is located:
Do you have a fenced yard?

yesno
If yes, what kind of fencing do you have?

woodenwrought ironchain linksplit railOther
And how tall is it?
Have you recently inspected your fencing for gaps, holes or unsecure areas?

yesno
Where will the dog sleep? (crate area, outside in the yard w/dog house, in the house) or other
Where will the dog spend the majority of the time?

kennel area/crateoutside in the yarddoggie day carein the houseOther
Where will the dog sleep?

crate areaoutside in the yard w/dog housein the houseOther
When you are not home, where will the dog be kept?

free roam of the houselimited to a room/areakennel/crateoutsideOther
Who will be the primary person responsible for the care of the dog?

youyour spousesignificant otherchild/childrenroommateOther
Home inspections are required prior to adoption. May we visit your home?

yesno
Please list the name, address and phone numbers of three references we may call:
Is there anything else you would like for us to consider as we review your application?
I affirm that the information provided is true and correct to the best of my knowledge.
Signature

Clear
Date

MonthDayYear
Date
Print name here
Should be Empty: