Dog adoption application

PHILLY RESCUE ANGELS

DOG ADOPTION APPLICATION
Thank you for your interest in adopting one of our dogs. Please fill out all of the information below in order to have your application processed.

This application is soley used to determine the best fit for you and the dog. This does not gurantee the dog you apply for will be yours. Your information will remain confidential and only be cused as part of the adoption process.
Personal Information
Name*

First NameLast Name
Todays Date*

MonthDayYear
Date
Date of birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
When will you be ready to adopt?*

TodayThis weekendWithin a weekWithin a month
Home Information
How many residents are living in your home?*
Names and ages of all permanent residents in your home (adults/children)*
I/We live in a*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
Do you plan on moving? if so, please explain how far and where you will be moving to. *
Renters, have you contacted your landlord to find out if there's any restrictions on the kind or size of dog you can have?

YesNoNot yet, but I willIt's written in our lease
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
Do you currently have any pets living in the home?*

YesNo
If you currently have pets, please list them below.
Are the current pets in your home neutered/spayed?

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 altered, please explain why below.
Are the pets living in your home up to date on shots?

YesNoWill be within the next 30 days, appointment has been scheduled. (We will call your vet to verify this.)
Vet reference (please call your vet and give permission to release information to us)
Vet name, address & phone number
Is anyone in your home allergic to dogs?*

YesNo
Does anyone in your home fear dogs?*

YesNo
Do you work outside the home?*

YesNoOne applicant is home/works from homeWe work different shifts
If you work outside the home, how many hours per day are you away?*
How many hours per day will this dog be alone? & where will the dog be while alone? Please explain.*
Where will the dog be sleeping in the home?*
Have you ever gave your pet away or surrendered your pet? if so, why?*
Have you discussed adoption with all members of your household?*

YesNo
Other Information
How would you describe your level of experience with dogs? *
EX: You've have many dogs in your life, Never had a dog, experienced in rescue/fostering dogs etc...
Are you applying for a certain dog? if so, please write the name of the dog below.*
Are you willing to work with a trainer if issues arise with the dog you adopted, that we did not previously know about before?*
If you do not have a certain dog in mind, is there any information you feel we need to know about what kind of dog you are looking to adopt?
Are you able to keep the dog separated from other pets in your home to allow a decompression period, if this is needed.*
What do you feel is a reasonable amount of time for an animal to adjust/decompress to living with you/your family?*
What would cause you to return the animal?*
Additional reference (if desired)
Do you have any additional comments, questions or general concerns? Anything else you would like us to know to help match you up ?*
Please read the above, check this box, sign, and click Submit.*

I/We have read and understand all of the above.
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:

Phillyrescueangels@gmail.com

Philly Rescue Angels INC. 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.

We are Registered, 501(c)3 Non-Profit Organization Focused on Animal Rescue and the Reduction of Animal Abuse.
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PHILLY RESCUE ANGELS

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