Adoption Application

Adoption Application

Misspits Rescue
* Please note: We seek homes in Western WA / NW Oregon. Due to breed restrictions, we may not be able to adopt to some areas. All dogs must be picked up at Misspits Rescue (or from their fosters) *
Date*

MonthDayYear
Which dog are you interested in adopting?*
How did you hear about this dog?*
Why do you want to adopt a rescue dog?*
What appeals to you about this particular dog?*
What are the most important characteristics you are looking for in choosing your ideal dog?*
Have you considered all of the costs involved in owning a dog? (Vet care including regular check-ups, dental cleanings, vaccines, and emergency care; quality food; fencing; liability insurance; rental deposits; training; etc.)*

YesNo
Are you financially capable of providing for this dog's nutritional, healthcare, and other needs?*

YesNo
Personal Information
Name*

First nameLast name
Age*
Email*
Physical address*

Street address

Street address

CityState / Province

Postal / Zip code
Phone number*
Format: (000) 000-0000.
Are you currently employed?*

YesNo
Who is your employer?*
What is your position?*
Are you the primary income earner in your household?*

YesNo
Who is the primary income earner in your household?*
What is your relationship to the primary income earner?*
Who is the primary income earner's employer?*
Do you live alone?*

YesNo

Are all of the people living in your household in favor of adopting a rescue dog?*

YesNo
What role will other household members have in training, disciplining, playing with, or caring for this dog?*
Do you plan to have children in the next few years?*

YesNo
Will this affect your desire or ability to have a dog?*

YesNo
Is anyone in your household allergic to animals, or does anyone in your household have any chronic conditions or disabilities that could affect their ability to live with a dog?*

YesNo
How do you plan to deal with this?*
Is anyone in your household afraid of or unaccustomed to dogs?*

YesNo
How do you plan to deal with this?*
How many consecutive hours a day are you usually away from home for work, school, or other regular activites?*
Where will this dog be if you are gone for more than four consecutive hours?*
How many hours do you expect to spend in the company of this dog on a typical working day?*
How many hours do you expect to spend in the company of this dog on a typical non-working day?*
Living Environment
Are you willing to allow a representative of Misspits Rescue to visit your home to verify that you can offer a safe, happy living environment for this dog?*

YesNo
Who will be this dog's primary caregiver?*
Do you plan to use a doggy daycare, dog-walking, or pet-sitting service?*

YesNo
What best describes your dwelling?*

CondoHouseDuplexApartmentTrailerOther
Do you rent or own?*

RentOwn
Do you have your landlord's permission to keep a dog?*

YesNo
What is your landlord's name?*

First nameLast name
What is your landlord's phone number?*
Format: (000) 000-0000.
Are you subject to any HOA restrictions?*

YesNo
Describe your HOA restrictions (breed, size, number of pets, etc.)*
How long have you lived at your current address?*
Do you plan to move in the foreseeable future?*

YesNo
How large is your yard (the area that this dog will have access to)?*
What best describes your yard's fence?*

Electric fenceFully fencedPartially fencedNot fenced
Describe the fence (type, height, etc.)*
Do you plan to install an electric fence in the future?*

YesNo
How do you plan to ensure that this dog receives safe and adequate exercise?*
Do you have a pool?*

YesNo
How will you keep this dog safe from the pool and prevent the risk of drowning?*
Where will this dog sleep?*
Where will this dog spend most of the day?*
Will this dog be outside while you are gone?*

YesNo
Will a doghouse or other shelter be available outside?*

YesNo
Do you plan to use a crate?*

YesNo
Do you plan to use a run or outdoor kennel?*

YesNo
Do you plan to tie this dog up outside?*

YesNo
Will this dog have yard access through a doggy door?*

YesNo
Preferences and Needs Affecting Choice of Dog

We would like to know what you are looking for in a dog. Please complete this section as though the dog you have requested is not available.
Would you be willing to consider a different dog if this one is not available?*

YesNo
Which breed(s) do you prefer and why?*
Please indicate the physical characteristics of your ideal dog.
Age*

Puppy (< 8 months)Adolescent (8-18 months)Young adult (1.5-4 years)Adult (4-8 years)Senior (8+ years)No preference
Sex*

MaleFemaleNo preference
Size*

Toy (< 9 lbs)Small (9-20 lbs)Medium (21-45 lbs)Large (46-80 lbs)Extra large (> 80 lbs)
Coat*

LongMediumShortHypo-allergenicNo preference
Are any of these physical characteristics especially important to you? Why?*
Please describe what you hope to receive from your ideal dog.
Role of dog in your life*

CompanionshipCompany for other dog(s)ProtectionPlaymate for child(ren)HuntingTherapy dogOther
What you are looking for in a therapy dog?*
Dog's energy level*

Couch potatoCasual walks and playRegular long walks and hikesJogging / runningHigh-level dog sportsOther
Dog's level of social activity*

Behave well around visitorsVisit friends' homesLittle social interaction likelyVisit public areas where there are dogsOther
Would you consider any of the following special needs?*

BehavioralMedicalLame / amputeeBlind / deafSpecial dietOther
Pet Ownership History
Do you currently own any pets?*

YesNo

If any of your current pets are not spayed or neutered, why not?*
What do you feed your current pets? (Type and brands of regular meals and typical treats)*
Where are your current pets during the day?*
Where do your current pets sleep?*
Have you owned any pets in the past? (If you are a young adult living in your first home or this is the first pet you are adopting, and you've lived with family pets before, answer Yes and list them below)*

YesNo

Do you have any large or small livestock animals or horses?*

YesNo
Describe your livestock animals and/or horses*
Will your dog interact with or have access to these animals?*

YesNo
Please describe how your dog will interact with or have access to these animals.*
Dog-related knowledge and opinions
What behavior do you expect from this dog when they first come to live in your home?*
Do you plan to train this dog?*

YesNo
Describe your training plan (Trainer or training school, level of training you hope to achieve, how much time you expect to spend actively training your dog)*
What are your opinions on disciplining a dog?*
Dogs under stress (e.g. on being introduced to a new environment) may mark territory by urinating indoors. How do you plan to deal with this?*
Some rescue dogs, especially puppies or adults who have spent a long time kenneled, may not be fully house-trained. How do you plan to deal with this?*
A rescue dog's behavior when they first come to your home may be negatively affected by their past experiences (e.g. they may be fearful, lack trust, not respond to cues, growl or snap, display anxiety, be needy, or be afraid to be left alone). How do you plan to deal with this?*
Most of the dogs we place are in good health, but some may have special healthcare needs. We provide adopters with full details about such needs and access to vet records before the adoption. If this dog needs immediate dental or medical care, are you willing to provide this?*

YesNo
Are you willing to keep this dog up to date on vaccinations for, at a minimum, rabies, distemper, parvovirus, and bordetella, and to protect against heartworm and other parasites as needed?*

YesNo
Are you willing to provide regular vet check-ups for the rest of this dog's life, plus medical care as needed?*

YesNo
Are you willing to provide regular dental care for this dog?*

YesNo
Some dogs live up to 18 years. Are you willing to care for this dog for that long?*

YesNo
Would you dock the tail or crop the ears of a puppy?*

YesNo
What is your opinion of pinch/prong collars or electric/shock collars?*
If this dog develops an expensive or time-consuming health condition, what will you do?*

Find them another homePay whatever it takes to manage or treatEuthanizeSurrender them to a shelterMake a decision based on prognosis and costOther
Sometimes unforeseen circumstances arise. If you can no longer care for this dog, what will you do?*

Find them another homeSurrender them to a shelter or private rescueEuthanizeOther
Under what circumstances would you give up a dog that has lived with you for more than two months?*

Divorce / separationDigging / destruction of propertyPersonal or family health issuesChildren lose interestMoving to different house / city / stateDeploymentPartner dislikes dogsNeighbor complaintsBarkingEscaping from yardNew babyDifficult to trainShedding / grooming requirementsHousebreaking problemsNo time to care for themAllergiesNoneOther
Questions for cat owners
Do you own cats?*

YesNo
Have your cats been declawed?*

YesNo
Why were they declawed?*
Are your cats accustomed to living with dogs?*

YesNo
How do you plan to introduce your cats to this dog?*
Cats can take a long time to accept a new canine family member, and sometimes they will react to a new dog by hiding, urinating in the house, acting scared, refusing to come in out of the rain, or a variety of other behaviors. How long are you willing to work with your cat(s) before returning a dog?*
Dogs that have been evaluated to be safe with cats could chase cats that run from them. What will you do if this dog chases your cats, gets into their space, or annoys them in some other way?*
Vet References

Please provide details about the vet you plan to use. If you have recently changed vets, please also provide information about your previous vet. Please give your vet permission to speak with a Misspits Rescue representative regarding your account.*

Rows	Vet and practice name	Address	Phone number	How long have they been your vet?
Current/future vet
Previous vet

Does your regular vet vaccinate your pets?*

YesNo
Where do you have your pets vaccinated?*
Personal References

Please provide at least three references who can attest to your suitability as a pet owner. We recommend that you provide at least three references; delays in contacting references are the biggest reason for delays in processing most applications. References must be adults, and only ONE may be a relative. Please notify your references that we will be calling them.*

Rows	Name	City/State	Phone number	Relationship
#1 (required)
#2 (required)
#3 (required)
#4 (optional)
#5 (optional)

IMPORTANT: All of the information I have provided is true and complete to the best of my knowledge. I agree to follow all rules and policies of Misspits Rescue. I understand it is my decision on whether to adopt an animal or not. I will not hold Misspits Rescue responsible for any damage, injury, or harm caused directly or indirectly to any person or property by any animal that I agree to adopt. Misspits Rescue, at its sole discretion, reserves the right to refuse any applicant for any or no reason. I agree that I will not make any claims against, sue or attach any property of Misspits Rescue, its directors, officers, agents, employees, and/or volunteers for any injury or damage caused by any animals adopted from Misspits Rescue. By submitting this application, I agree to all stated policies, releases, and waivers.*

Agree
Signature*
Should be Empty:

Rows	Name	Species (dog, cat, etc.)	Breed	Age	How long in your care	Sex	Spayed / neutered?	Up to date on vaccines?	Good history with dogs?
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Adoption Application

Personal Information

Living Environment

Preferences and Needs Affecting Choice of Dog

Pet Ownership History

Dog-related knowledge and opinions

Questions for cat owners

Vet References

Personal References