Rescue Dog Adoption Application

Adoption Application
Applicant Information
Your full name:*
Street Address:*
City, State, Zip*
Phone:*
E-mail:*
Character reference and phone number:
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?

YesNo
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fully fenced yard?*

YesNo
Do you have any of the following?

Underground fenceKennelDog Run
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?
Have your children been around animals before?

YesNo
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages
How many of these pets are spayed/neutered?
Where are these animals now?
Have you adopted from an animal welfare group before?

YesNo
If yes, what group?
Have you ever given up a pet?

YesNo
If yes, what were the circumstances?
New Pet Information
Are you aware of crate training?*

YesNo
Have you ever house-broken a dog or puppy before?*

YesNo
How many hours each day will your new pet be home alone?*
Where will your new pet sleep at night?*
Where will your new dog stay when nobody is home?*
What length of time will you allow your new pet to adjust to his new home?*
Do you agree to feed this dog a high quality food?

YesNo
Are you willing to work through your new pet's issues, if any?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Do you understand that a dog is a long-term commitment and can be costly to care for?*

YesNo
Do you plan to take an obedience class with your dog?*

YesNoNot sure
What circumstances would lead you to give up your new dog?*
Most of our dogs are not housebroken as they have lived in a kennel their entire lives. Are you willing to potty train your new dog?

YesNo
If you had to give up your dog, what would you do with him/her?*
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
I require a virtual home visit. Do you agree to arrange a video call prior to adoption?

YesNo
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Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information