A Dozen Roses Animal Rescue Pre-Adoption Form

Pre-Adoption Application Form

A Dozen Roses Animal Rescue - New Brunswick
What animal are you interested in?*
Your name*
First & Last Name
Your Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Your Email*
Your Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Names and ages of all permanent residents of your home (adults/children)*
Please list any pets currently living in your home, and if they are vaccinated and altered.*
Vet reference - do we have your permission to contact your vet?*
Vet name, address & phone number
Are you planning to move in the near future?*

YesNo
Is anyone in your home allergic to the animal you're hoping to adopt?*

YesNoYes, but it is tolerable for them and they are OK with it.
Do you rent or own this property?*

RentOwn
If you rent, you must have a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have animals in your dwelling.
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
Have you discussed this adoption with all members of your household?*

YesNo
Please be aware that dogs/cats given as gifts for the holiday season are usually returned to shelters or given to pounds after the New Year's. With this in mind, please make sure that any animal you are adopting will be a permenant resident.
Are you prepared for the expense of a pet for the next 10-12 years?*
Please list 3 references (at least one should be a non-family member) along with their phone numbers.
Do you have any additional comments, questions or concerns?*
Signature*
Signature date*
Thank you for taking the time to submit this form. Please feel free to contact A Dozen Roses Animal Rescue with any questions. Thank you!
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Pre-Adoption Application Form