My Peace Animal Rescue Adoption Application Form

Adoption Application

My Peace Animal Rescue, Alice TX
Applicant Information:
Your Name (First & Last):*
Street Address:*
City, State, Zip*
Phone Number:*
Alternate Phone:
E-mail:
Employer:*
Employer reference & phone number:*
How do you prefer to be contacted?*

PhoneTextEmail
About Applicant:
Please provide the name of the pet you are interested in, or "No Preference"*
Please list all current pets in the household: (Breed, age, spayed/neutered)*
Please list previous pets from the last 5 years & where they are now:*
Are you considering adopting more pets in the future?*

YesNo
Choose which best describes your level of dog owning experience:*

Advanced (Dog behavior & training background)Intermediate (Always owned dogs)First Time (Never had a dog)Need Help Finding a good fit
What qualities are you looking for in a companion?*
What activities would you like to do with your new pet?*
Would you consider adopting a pet with existing medical needs, that are currently being treated?*

YesNoMaybe
What do you plan to do with the animal if you move? What if there are restrictions pertaining to your pet?*
Household Information:
Are all members of your household in agreement with this adoption?*

YesNoI Don't Know
Do you agree that, in the event you are no longer to care for your pet, you are solely responsible for that pet to be returned to our rescue.*

YesNo
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoOther
Do you own or rent?*

OwnRent
If renting, please provide name and contact number for landlord/property management:*
Does your landlord/property management/HOA allow dogs at your residence?*

YesNo
Are there any restrictions from your landlord/property management/HOA?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Size of your backyard:*

SmallAverageLargeExtra Large (Corner lot)Patio (No Yard)
Do you have a fully fenced yard?*

YesNo
Height & type of fence: (N/A if not applicable or no fence)*
Where will the pet be kept when you are not home?*
How many children are in your household?*
Please list children's ages:(N/A if no children)*
Have children in the home been around animals, before?*

YesNo
Does anyone in your home have asthma or pet related allergies?*

YesNo
Household Activity Level:

QuietActiveVery ActiveJust MeOther
Please list 2 personal references with phone numbers: *
Current/Previous Pet Information:
Do you currently have pets?*

YesNo
Please list all current pets: (Breed & Age included) (N/A if no pets)*
Are your pets up to date on vaccines & preventatives? If not, briefly explain why:*
How many of these pets are spayed/neutered?*
Have you adopted from a rescue group or shelter, previously?*

YesNo
If yes, which rescue/shelter?*
Have you ever had to surrender an animal?*

YesNo
If yes, please briefly explain the circumstances?
Please list any pets you have owned in the last five years & where they are now: (N/A if not applicable):*
Which of the following would you like more information on?*

VaccinesParasitesHeartworm/PreventionFlea/TickSpay/NeuterSocializationTrainingNone
Do you have a vet you use, currently?*

YesNoI would like help finding one
If so, please provide the name, address, & phone number of your vet:
Adoption Information:
Briefly explain why you are interested in adopting? (N/A for Fosters)*
Preferred activity level:*

High Energy/Jogging buddyModerate ActivityLow ActivityCouch Potato
Do you plan on crate training your new pet?*

YesNo
Have you ever potty-trained an animal before?*

YesNo
Where will your new pet sleep at night?*
How do you plan on helping your new pet best adjust to their new home?*
- I agree that the information I have provided is true
- I understand that applying does not guaruntee adoption
- I understand that the information the rescue provides inregards to the dogs is "Best Guess" unless a dog was surrendered and actual information was given.
- I understand that dogs need to decompress. This could take anywhere from 3 weeks to 3 months or more.
- I agree to provide a safe & loving environment for my pet.
- I Agree to cover necessary costs to send the dog back to the rescue if I am no longer able to care for him/her.
- I understand that, in the event I breach this contract, legal action will be taken upon me.
Signature

Powered by Jotform SignClear
Name

First NameLast Name
Date

MonthDayYear
Date
Please allow 2-3 business days to process your application. You will get an E-mail/Text regarding our decision!
Should be Empty:

Adoption Application

Applicant Information:

About Applicant:

Household Information:

Current/Previous Pet Information:

Adoption Information: