JR's Pups-N-Stuff Dog Application

Applicant is 21 years of age or older

All adults living in the household have knowledge of and consent to the submission of this application

Application will contain accurate veterinary information for all animals owned by us or another member of our household for the past 10 years

All animals in our home are up to date on annual wellness exams, all required vaccinations (rabies and distemper) as well as spayed/neutered

This application requires approval by JRs Pups N Stuff Inc

JRs is a foster based rescue and meeting dogs is done by appointment

JRs does not adopt puppies (dogs under 6 months of age) to families with children under the age of 8

Understand that failure to authorize my vet to release information to JRs will result in a significant delay in my application being processed

Date of Birth

Date

Name

First NameLast Name

List the full name and date of birth for ALL people living in the house.*

JR's will check available public records for all adults in the household. Please provide any additional information you would like us to consider regarding any charges or outstanding financial judgments.

In our household we have:
Number of adults (18 or older): number of adults*
Number of children (under 18): number of children*
Number of dogs: number of dogs*
Number of cats: number of cats*

Address*

Street Address

Apartment / Condo Unit Number

CityState

Zip Code

Primary Phone*

Secondary Phone

Applicant's email address*

Confirmation Email

Co-Applicant's email address

Confirmation Email

HouseApartmentCondominium

RentOwn

YesNo

Landlord's Name

First NameLast Name

Landlord's Phone Number

Landlord's email address

example@example.com

What are the breed, weight, and size restrictions that you need to follow in your complex, community, or homeowner's insurance?

I understand that I am required to comply with complex or community ordinances, including licensing. If the city listed in your address is not the municipality whose ordinances you follow, please note the name of the municipality below:

Name, Breed, Age of all animals owned in the last 10 years:

Vet/Clinic name, phone number for all above listed animals:

YesNo

Approximately how long ago?

What was the animal's JR's name?

YesNo

Please list ALL household pets, alive or deceased, that you have had in the past 10 years. Please note, a JR's volunteer will reach out to your vet to verify your pet(s) are up-to-date on vaccinations.

Who is (was) your veterinarian for the above animals? If your pets see different vets, please list all vets you are using/used. Please understand applications will not be processed without this information. Failure to contact your vet could result in significant delays in processing your application.

If you no longer own any of the pets listed above, please share what happened to the animal(s) and when.*

YesNo

Please tell us what prompted you to rehome your dog or cat. When did this happen? What, if anything, would you do differently?

What conditions would cause you to re-home (return to rescue) a future pet?*

NoYes, dogsYes, catsYes, both cats and dogs

What is done to manage the allergies?

How much do you anticipate spending yearly to feed, vaccinate, license and provide routine medical care for your pet?*

What do you consider an appropriate reason for euthanasia of a pet? *

YesNo

Based on the age or breed you are considering, what is your plan for day-to-day care? How do you intend to exercise and train your dog?*

It may take your new pet several weeks to adjust to its new home, especially if other pets or children are involved. What steps are you willing to take to help your pet adjust to his/her new home? *

Comments or additional information you would like to provide to assist us in identifying the correct dog for you. Or, if you would like to clarify anything for us. JR's applications are not for a specific dog. If you are completing this application for a specific dog, please understand that it is possible that the dog will be adopted prior to your approval to adopt from JR's.

Signature: By signing below, I certify that the information I have given is true and I recognize that any misrepresentation of the facts may result in my losing the privilege of adopting a pet. I authorize investigation of all statements on this application. Verification of vetting, landlord, and available public records will be checked for accuracy of information. I understand that this application is property of JR's Pups-N-Stuff Inc.*

(Typed or electronic signature accepted)

YesNo

My Products*

New Application Processing Fee$5.00

Total $0.00

YesNo

Which dog/litter was it?*

Event Name/Location:

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