Chasing Sunshine Dog Rescue Adoption Application

Chasing Sunshine Dog Rescue Adoption Application

Thank you for your interest in a rescue dog!
Name of dog you wish you adopt? *
Dog Name
How did you find out about the dog?*

FriendFamily MemberFacebookInstagramVeterinarian's OfficeOther
ALL ABOUT YOU
Your Full Name *

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you lived at the address listed above?*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What type of phone number is listed to the left?*
Date of Birth*

MonthDayYear
Date
Employer*
Are you on Facebook?*

YesNo
If yes, what is your Facebook name?
Are you on Instagram?

YesNo
If yes, what is your Instagram Account?
YOUR HOUSEHOLD
Are all members of the household in agreement to adopt a dog?*

YesNoWe have not discussed it yet.Other
Who will be the dog's primary caregiver? *
Why do you want to add a dog to your home now? *
Do you have a fence?*

Yes, physical fence.Yes, invisible fence.No.Partially fenced but not completely secure.We plan on fencing in part or all of our yard.
What type of home do you have?*

HouseCondoApartmentTrailerHouse-boatOther
If you chose "condo" above, kindly email the pet policy section of your by-laws to ChasingSunshineDogRescue@gmail.com.
Do you own or rent your home?*

OwnRentOther
If you rent, please provide your Landlord's name and phone number.
Please list the full names of all the adults in the home:*
Example: Joe Smith, Jane Smith and Sally Brown
Please list the NAMES and AGES of all the children in your home:*
Example: John (3 years), Mary (10 years) & Carol (10 years)
If you have children, have they been around animals before? Please explain:*
Does anyone in the home have allergies? If yes, please explain:*
PERSONAL REFERENCES

Please list 3 personal references below. We ask that only 1 reference is a relative. Kindly notify your references that you listed them on a dog adoption application so they will be expecting the phone call. Thank you!
Personal Reference #1*

First NameLast Name
Phone Number*
Please enter a valid phone number.
What type of phone is this?*
How do you know this person? *
Example: Co-worker, Friend, Neighbor, etc.
Email
example@example.com
Personal Reference #2*

First NameLast Name
Phone Number*
Please enter a valid phone number.
What type of phone is this?*
How do you know this person? *
Example: Co-worker, Friend, Neighbor, etc.
Email
example@example.com
Personal Reference #3*

First NameLast Name
Phone Number*
Please enter a valid phone number.
What type of phone is this?*
How do you know this person? *
Example: Co-worker, Friend, Neighbor, etc.
Email
example@example.com
PET HISTORY
Please list ALL the animals you have had in the last 20 years. Indicate if you still have them or what happened to them. If they were spayed or neutered, their species and age. *
Example: King, dog/German Shepherd (neutered, died at age 12). Dolly, mix (spayed/ age 2 ).
Have you adopted an animal before?*

YesNo
If yes, from where ?
Name of rescue or shelter.
Have you ever surrendered or rehomed a pet before? Please explain in detail:*
VETERINARIAN INFORMATION

Below, please list the Veterinarian you have used (in the last 20 years) or currently use. If you do not have a Veterinarian because you are a first time pet owner, please list the one you WILL be using should you adopt this rescue dog.

PLEASE CALL THIS VETERINARIAN LISTED AND GIVE PERMISSION FOR YOUR VET HISTORY TO BE DISCLOSED TO PROCESS THIS APPLICATION. Let them know you have applied to adopt a dog and a volunteer will be reaching out.
Veterinarian *
Clinic Name
Veterinarian's Phone Number*
Please enter a valid phone number.
This Veterinarian is:*

CurrentPastPlan on using with this dogOther
LIFE WITH YOUR NEW DOG

We feel it's important to make a proper match when placing a dog. Not just people to dog, but dog to people, dog to the home enviornment and the family's schedule. All of these are factors in a smooth transition process and proper fit for all. It's important to answer these questions honestly.
Describe your ideal dog for your home. This will help us ensure a good match. *
Be sure to think of your daily scheduel and lifestyle.
Are you familiar with crate training? And how do you feel about using a crate in your home? *
How many hours a day will your dog be left home alone. Please explain. *
Where will your dog sleep at night?*
Where will your dog be allowed while you are not home? *
Do you plan on taking obedience classes with your dog?*

YesNoI would consider it. I'd like more information.I have been thinking about it but have not decided.Other
If your dog has an accident in the house, what type of corrective training do you plan to use? *
How long are you willing to allow for your new dog to adjust to your new home? *
Are you aware that a new environment for a dog can be stressful and they need time to adjust and decompress? They may display uncharacteristic behavior during this period of time.*

Yes, I'm aware.Yes, I've experienced it with other pets.No.I would like more information please.Other
What circumstances would lead you to give up a pet? And what would you do if you faced this sort of decision?*
Do you understand that having a dog will cost a minimum of $800.00 to 1,000.00 per year in basic yearly routine vet care and preventatives?*

YesNoI would like more information on costs.Other
Please put any additional information here that you would like to share with the adoption team.
Please read below to better understand our adoption process:

I understand the adoption process includes: a completed application, a check of my personal and vet references, permission form Landlord (if applicable), home ownership verification (if applicable), a phone or in person interview and a home visit (with all family members present).

I understand my responsibilities as an adopter includes: providing my new dog with vet care, including checkups, booster vaccinesines or titer tests, flea/tick preventative, heartworm prevention, medications as needed, etc. I will be solely responsible for the health safety and behavior of my new dog.

Once adopted I release and hold Chasing SunShine Dog Rescue and their volunteers harmless from responsibility for any medical expenses incurred on behalf of this dog and for the behavior of this dog. If at anytime in the future I cannot care for this dog I will contact Chasing Sunshine Dog Rescue for re-homing and will under no circumstances bring this dog to a shelter or give away to another person.

I understand that meeting a rescue animal can carry a risk and I will not hold Chasing Sunshine Dog Rescue or their volunteers liable for any harm that comes to me or my family during a meeting with the animal. I will follow all directions on how to greet an animal as given.

By completing this form, I agree to all the terms listed within it.
Applicant's Signature*

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