Adoption Application

K9 Rouge Rescue
Adoption Application

Full Name*

First NameLast Name

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Cellular*

Area CodePhone Number

Date of birth*

Date

What is your occupation?*

What type of home do you live in?*

Do you rent or own?*

RentOwn

If you rent, please provide the contact information of your landlord.*

How many adults live in your home?*

How many children live in your home? Please list their ages.*

Is everyone in your household aware you are adopting a new pet?*

YesNo

Does anyone in your household have allergies?*

List all pets you have owned in the last 3 years. Please include name, age, breed for each pet. *

Are all of your current pet(s) up to date with their vet including vaccinations and annual care? Are they spayed and/or neutered?*

List the veterinarian or animal clinic where your current pet(s) receive care. A vet reference is mandatory for application approval. Please provide a contact number.*

Have you ever sold a pet, rehomed a pet, given away a pet, or surrendered a pet to a shelter and/or rescue group? If yes, please specify why and how long ago.*

Why do you want to adopt a new pet?*

Is there a particular dog/puppy you are interested in and want to adopt? If so, what is their name? Feel free to include multiple names if you are unsure.*

Who are you adopting the pet for?*

Who will be the primary person responsible for this pet?*

Where will this puppy/dog live?*

InsideOutsideBoth in/outOther

How many hours per day will your new pet me left alone without a person in the home?*

Where will the puppy/dog stay when you leave the house?*

Do you have a fence? What is the fence height?*

Where will your pet sleep?*

What methods will you use to train and discipline this puppy/dog?*

How much money do you plan to allocate to your new pet for annual care including veterinary care, flea preventative, and heartworm preventative?*

Are you aware we require all canines in our program be spayed or neutered?*

YesNo

What steps would you take to ensure the safety of your pet(s) if you have to move or evacuate your home? (ex.. hurricane or natural disaster)*

In the event that you become unwell and are unable to care for this pet, do you have someone designated to care for your him/her? If so, have you discussed this with them?*

Most of the time we receive multiple applications for the same canine that we have to choose from. Explain why your home and lifestyle would be a better fit for this puppy/dog?

Please list any referrals from either a K9 Rouge volunteer or a previous adopter.

By signing this form electronically, I acknowledge that I have completely read this form and comprehend it fully. I certify that the information I provided is accurate.

I also understand that I may be contacted about this application but continued contact is not guaranteed, nor is the placement of the canine I have requested or any canine from this program.

I further understand that coordinators at K9 Rouge Rescue may require additional information and a home visit to continue with the application process.

Date*

MonthDayYear

Electronic Signature*

Your digital signature authorizes K9 Rouge Rescue to contact your vet for reference.