Form
Name
First Name
Last Name
Preferred Pronouns
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of birth
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Email
example@example.com
1. We kindly ask that if you are not ready to bring a dog/animal home and/or have vacations or other commitments planned in the foreseeable future, please wait to apply until your schedule is free. We cannot hold dogs to accommodate your schedule. You will also have to read and sign the 3-3-3 Rules before taking home a new rescue pet.
2. Which dog are you interested in (name):
3. If the dog you are interested in is not listed, or if you are interested in multiple dogs, please enter their name(s) here:
4. How many people reside in your household?
5. Please list household members by gender and age:
6. Are you employed outside the home?
7.. List your current pets, species/gender/spayed/neutered/UTD on vaccines:
8. We like to help you to find the perfect match for you. Please tell us a little bit about your lifestyle. How would you best describe yourself?
9. What is your ideal dog relationship?
10. Have you ever given up a pet? If yes, please explain:
11. Will the dog be kept inside or outside?
12. How much time will the dog spend alone during the day?
13. Where will the dog be kept when you are home?
14. Where will the dog sleep?
15. Where will the dog be kept when you are not home?
16. In what type of home do you live?
17. Do you own or rent your home?
18. If you rent, have you received the approval of your landlord to have a dog?
19. Is your yard fenced? What is the height of the fence?
20. What type of fence? We do NOT approve of invisible fences! Those are cruel and abuse to the animals!
21. *REQUIRED! Please list first References Name, Phone Number AND Email Address. (Not living in the same household as the applicant)
22. *REQUIRED! Please list second References Name, Phone Number AND Email Address. (Not living in the same household as the applicant)
23. *REQUIRED! Please list third References Name, Phone Number AND Email Address. (Not living in the same household as the applicant)
24. Your vet information
25. Do you have a criminal record (in regards to animals)?
26. I certify that the information entered on this application is true. Enter your name and date
27. Please make sure to read the 3-3-3 Rule. Every dog is different, and every dog needs a different amount of time to feel safe and comfortable. You need to give a new rescue dog time and not take them to big family gatherings or public places until they feel comfortable around you and others.
28. Please make sure that the application is completely filled out. If there is any unanswered question, we cannot move forward with the application. Completed by
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