GRGRescue Inc. Adoption Application

Animal Adoption Application

This application does not verify acceptance of any animal applied for this application is verified as an inquiry to a specific animal or as a general application to the rescue. Please understand there will be more information we will need based for approval.
Name*

First NameLast Name
Date of Birth:*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How Long have you been at this address?*?
If Renting:    Landlord's Name:   First Name   Last Name
Landlord's Phone Number:        Area Code   Phone Number
Type of Home Rented:
Family & Housing
How many adults are in the home? (What are their relationship to you).*
How many children are in the home? (What are the children's ages). If you do not have children please put N/A. *
What type of home do you live in? (Single-Family, Townhome, Apartment, Farm, Etc.).*
Please describe your household.*

ActiveAverageNoisyQuietOther
If you stated "Other" to your household option; please explain.
If you rent, please list the governing rules according to your lease regarding pets. Please attempt to email attach a copy of your pet policy, please send your Landlord or Property Managers information to the rescue. IF you own please have a copy of your mortgage or deed to the home for proof of ownership. (if you own your home please type "I own" in this box). For Renters, please follow according. If you are renting and you do not give accurate details, you will IMMEDIATELY be denied. *
Does anyone in the family have an allergy to animals, that could prevent you from keeping the animal?*
Is everyone in the household in agreement with the adoption of the selected animal(s)?*

YesNo
Do you have adequate time, love and attention to provide to the animal you plan to adopt?*

YesNo
Please upload a copy of your Lease Agreement, Mortgage/Deed(if home owner), Seller's Financing Agreement, or Lease to Own Agreement:*

Cancelof
What days are best for home checks: (Please select all that apply; this is required to adopt a pet from "GRGR")*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
What time of the day is best for home checks: (Please select all that apply; this is required to adopt a pet from "GRGR")*

DayAfternoonEvening
Other Pets

Please let GRGR Inc. know of the other pets in the household prior to the home visit.
What other pets do you have in the household? (Please specify; type and number of pets)*
Please list name and age of pets in the home: (This is to ask the vet for reference; if your pets were deceased in the last year and you have no current animals please list them.) If you have no animals and this does not apply please put "N/A"*
Are all current pets in the home up to date on vaccines?*
Are all other current pets in the home neutered or spayed? *
If your current pets are not neutered or spayed, please provide the reasoning as to why they are not neutered or spayed. (This will not disqualify you as an applicant but it can determine placement of the current animal, this is evaluated on a case-by-case basis.) If this does not apply please put N/A.*
Have you ever needed to surrender a pet to a rescue, or shelter? If so please explain why? *
Have you ever had to have a pet euthanized, if so please explain why? *
Have you ever lost a pet to an accident? If so please explain. *
Do you discipline your pets? If so why, and how? *
If you are applying for a dog, what is your training method? How would you go about training. (If this does not apply, please put N/A.)*
Veterinarian

Please give your veterinarian consent to release your records to us, and let them know that a rescue is calling to get information for your future adoptive pet.
Do you have a regular veterinarian? Yes No*
Veterinarian's Clinic Name: *
Veterinarian's Name: *

First NameLast Name
Veterinarian Clinic Address: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Veterinarian Clinic Phone Number: *
Please enter a valid phone number.
About the Animal

Please tell us about the animal you wish to adopt.
Name of the animal you are looking to adopt from "GRGR"? (If this is a general application please put "General".)
Where will the animal spend the day? (Please describe.)*
Where will the animal spend the night? (Please describe.)*
Number of hours on average the animal would spend alone? (Estimated)*
Who will have primary responsibility of this animals daily care?
Who will have financial responsibility for this animal?*

First NameLast Name
Who will have financial responsibility for this animal?

First NameLast Name
Do you agree to provide regular healthcare to this animal by a Licensed Veterinarian?*

YesNo
Do you agree to keep your animal as an indoor animal?*

YesNo
When the dog goes out, how do you plan to supervise it? (If this does not apply please put N/A.) *
Do you have a fenced yard? If adopting a dog. (If this does not apply please put N/A.)*
Do you agree to contact Gone Rogue Girls Rescue Inc. if the pet needs to be reclaimed, or you can no longer keep the dog? (Per adoption policy, you are to bring back to GRGR.)*

YesNo
Are you willing to let a Gone Rogue Girls Rescue Inc. qualified representative come to your house for a home check, and interview?*

YesNo
Would you be interested in fostering an animal from Gone Rogue Girls Rescue Inc.?*

YesNoWould like to learn more!
Personal References

Please let your personal references know that the rescue will be reaching out to them, please let them know we will need to verbally speak with them and it will not be through text message.
Personal Reference #1:*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Years Known:*
Relationship to Personal Reference #1:*
Personal Reference #2:*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Years Known:*
Relationship to Personal Reference #2:*
I "ADOPTER" attest, that all of this information I have given to Gone Rogue Girls Rescue Inc. is true and complete. This animal will reside in my home, and as my pet if selected as the appropriate applicant for the requested pet. I vow that I will provide it with quality food, plenty of fresh water, indoor shelter, affection, and physical wellness examinations with a licensed veterinarian as directed. I understand any perjury on this application will result in denial of this application, and can result in future denials of any further applications.
Signature*

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Animal Adoption Application

Family & Housing

Other Pets

Veterinarian

About the Animal

Personal References