Pet Adoption Application Form

Raise the Woof Nola Rescue Inc Adoption Application, Contract and Waiver

Name of Pet You Wish to Adopt*

Name

First NameLast Name

Date

Phone Number

Please enter a valid phone number.

Email

example@example.com

Street Address

Street Address Line 2

City

State

Postal / Zip Code

Please list all cities/states lived in over the past 10 years

Do you own any pets?*

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other dogs?

Please provide your veterinarian's name and phone number and/or email address

Please list employer and phone number for reference

Do you live in a home, apartment or mobile home?

Do you have a yard, is it fenced? please describe

Do you own or rent your home?

OwnRentOther

If you rent, please provide landlord's name and number/email address

Does your landlord have a pet policy? Please tell us what that is

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?

YesNoOther

If you answered "Yes" to the above question, please provide details:

Are there children in the home? (If yes, please list ages)*

How many hours per day would the pet be alone?

Will you crate your pet?*

Will your adopted dog be an "outside" dog. Please explain*

If you have to leave town, emergently or planned, where would your pet stay?*

How would you deal with behavioral issues such as barking, chewing. destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

Personal Reference Information #1

Personal Reference Information #2

Personal Reference Information #3

This questionnaire is designed to help Raise The Woof Nola Dog Rescue determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Raise The Woof Nola Dog Rescue reserves the right to deny any adoption based on answers to this questionnaire, reference checks, and/or interviews prior to adoptions. By clicking the submit button, I agree to Raise The Woof Nola Dog Rescue's adoption process, will undergo a home check, and interview at the discretion of Raise The Woof Nola Dog Rescue. By clicking the submit button, I understand Raise The Woof Nola Dog Rescue will check my references including veterinary, employment, and personal. By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Raise The Woof Nola Dog Rescue and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet. By clicking the submit button, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Raise The Woof Nola Dog Rescue BY EMAIL at raisethewoofnola@gmail.com and provide a 14-day period to allow Raise The Woof Nola Dog Rescue to make arrangements for my pet to be taken back into rescue. By clicking the submit button, I agree to indemnify and hold harmless Raise The Woof Nola Dog Rescue against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed. By clicking the submit button, I understand that Raise The Woof Nola Dog Rescue will disclose any of the pet's health or behavior issues known by the above-named rescue group before adoption is completed. By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Raise The Woof Nola Dog Rescue and provide transport to where Raise The Woof Nola Dog Rescue deems appropriate. By clicking the submit button, I verify all the above information is true and accurate.

Signature of Potential Pet Parent*

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