Summit Dog Rescue Adoption Application

Adoption Application

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Applicant's General Information
Full Name of Applicant*

First NameLast Name
Occupation:*
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Co-Applicant (Spouse, significant other, roommate):
Personal Email:
Occupation/Employer

Please list all the people in your household. *

	Name	Age
Self
Person #2
Person #3
Person #4
Person #5

Please list all pets in your household. Include both current. *

	Species & Breed	Age	Gender	Spay/ Neuter?	Residing with you?
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Do you have your heart set on one specific DDR dog? If so, who is that? It helps us to know whether you are only applying for a particular dog or are flexible in your options.

Questions Regarding Vet Care
Please give a veterinary reference if you have one. A past reference is fine. Name, address, phone number. *
Do you plan to get insure your pet? (We can help recommend)

YesNo
What brand of dog food will you feed your dog? *

Almost Done!
Have you ever lived with a dog from a rescue organization or shelter?

YesNo
Do you agree to contact Darling Dog Rescue if after adoption you are unable to continue to be a guardian for your adopted dog, and either return your dog to us or work with us to find another suitable home for your dog?

YesNo
Do you agree to pay the adoption fee?

YesNo
All surgeries and vet visits MUST have a 24 hour notice for cancellation to reschedule and get deposit back for appointment. If you are a no show you will be responsible for the $30 deposit fee for a reschedule. 2nd missed appointment pet will need returned to rescue. Do you agree to terms?

YesNo
Please list three personal references (not a relative or household member), whom you have known for at least three years, who can vouch for your character as a pet guardian. Give name, address, phone, and email:
Reference #1; Name and Relationship, Address, Phone, Email*
Reference #2; Name and Relationship, Address, Phone, Email*
Reference #3; Name and Relationship, Address, Phone, Email*
The full dog adoption process includes a personal reference check! Submission of this application confirms that you understand and agree to the need for screening of adopters and certify that the information supplied on this application is true and correct. The terms “guardian” and “owner” shall be considered interchangeable. Please initial here that all your responses are truthful and complete.*
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Adoption Application

Doggie Wishlist

Behavior