Dog Adoption Application

Only Fluffs Animal Rescue Dog Adoption Application
Name or description of puppy/dog you're applying for:*
Adopter's Name*
First & Last Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Adopter's E-mail*
Phone Number*

Area CodePhone Number
CellHomeWork
Names and ages of all permanent residents of your home (adults/children)*
YesNo
List all pets that you have owned in the last 5 years including species, breed, name, age, gender, and what happened to them if you do not currently have them.
YesNo
If your current pets are not altered, please explain why below.
Vet reference *
Vet name, address & phone number
Two Personal References*
TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
RentOwn
YesNoNot yet, but I willIt's written in our lease
If you rent, you must show us a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have dogs and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have a dog there and show any restrictions.
Less than 800 square feet800-1,000 square feet1,000-1,500 square feet1,500-2,000 square feetOver 2,000 square feet
Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
2' high3' high4' high5' high6' high
Approximate dimensions of your lot:*
YesNoOne applicant is home/works from homeWe work different shifts
How many hours per day will this dog be alone? Please explain what you plan to do with your dog/puppy while you're away*
YesNoYes, adults have discussed. Kids don't know yet.
Upon meeting the dog, what would give you cause to not want to adopt it? Please explain.*
How much do you feel you can reasonably afford and would be willing to spend on your dog per YEAR (for things like veterinary care, licensing, ID tag, food, toys, crate, other supplies, training, pet sitting, etc)? *
Wild and crazy is coolLeash trained daily jogging partner would be excellentMedium energy, plays a bit then hangs out with youLow energy, walks slowly on leash, a total couch potatoOther
As a family petTo breed with my dogTo train/use for huntingTo train/use for agilityTo train/use as a therapy dogTo train/use as an assistance dog for the disabledTo use as a guard dogFor a jogging/hiking partnerTo interact with lots of friends/familyAs a gift for a friend, partner, or family memberAs a companion for my dog(s)As a companion for my cat(s)As a companion for my child/childrenTo be fully house trained prior to adoptionOther
Be kept outside most of the timeBe kept indoors most of the timeBe left outside during the work day while we are awayBe kept inside while we are awayBe crated when we are not homeHave free reign of the house when we are not homeBe taken to formal obedience classesBe trained by me/usTake frequent car rides with usBe kept on a lead line/cable in the yardBe mostly interacting with adultsBe interacting frequently with children under 8Be interacting frequently with older childrenWill be housetrained by usWill be walked more than one mile per day every dayWill be walked occasionallyBe attending formal group obedience classes with usBe trained by us without the advice of a trainerHave private sessions with a trainer as neededBe attending agility classesBe taking frequent car rides/trips with usBe boarded when we go on vacationStay with family when we go on vacationBe given away to someone else if we feel it's not a good match for usBe turned in to a shelter if we can't keep itBe going camping with usBe going on boat trips with usBe outside with a dog house in a fenced areaBe outside chained/tethered to a dog houseBe free roaming on the farm (unfenced)Other
HousebreakingChewingJumpingPulling on leash during walksCounter surfingObedience trainingFear of menFear of womenFear of childrenMouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training)GrowlingBarkingRough play with my dogHigh activity levelFood/toy aggression/not willing to share with other dogsFood/toy aggression with peopleWhining/cryingCounter surfingBlindnessLimited SightDeafnessSeparation AnxietySpecial DietLong Term MedicationIncontinence / Leaking UrineGets stressed/carsick when riding in vehicleDoesn't know how to climb stairsCan't climb stairs due to age/arthritis/health issuesHeart conditionSkin allergiesFood allergiesTrimming nailsI will do whatever it takes to help this dog adjust and work with a trainer to help resolve any training needs.Other
What would cause you to return a dog?*
What do you feel is a reasonable amount of time for a dog to adjust to life with you/your family?*
How do you plan to integrate this dog into your family?*
Additional reference (if desired)
If the pet you are interested in is NOT a fit for you based on your answers or is no longer available, please describe what you are looking for:*
I understand that completing this application does not guarantee I will be allowed to adopt a dog, and that the application is a tool to help The Rescue determine if this dog and my family are a good fit for each other. I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the adopted dog from my possession. I also certify that I have never been convicted of animal cruelty or neglect.
I/We have read and understand all of the above.
Applicant's Signature*
Co-Applicant's Signature
Signature date*
Sumitting this application does not mean you are commiting to a dog, nor does it guarantee you will get that dog. It is simply a tool we use to help identify a good potential match for your family and lifestyle.

A successful adoption depends on selecting the right dog for your household and a good understanding of the dog's needs and care requirements.
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Only Fluffs Animal Rescue Dog Adoption Application