Robbins Rescue Ranch Adoption Application Form
Name of Dog Interested in Adopting
*
Applicant Details
Name
*
First Name
Last Name
Age
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (Mobile)
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Why do you wish to adopt this dog?
*
Please list all people (include relationship and age) living in the home where dog(s) will reside
*
Does anyone in your household have allergies to animals?
*
Have YOU, ANYONE LIVING IN YOUR HOME, OR ANYONE WHO WILL FREQUENT YOUR HOME been charged with animal abuse, neglect, abandonment, cruelty, or any potential criminal acts directly or indirectly related to the harm, intent to harm or endanger, or mistreatment of animals? If yes, please describe:
*
I / We live in a
*
Single Family Home
Duplex / Twin
Condo / Townhome
Trailer
Apartment
Other
Do you own or rent?
*
Own
Rent
Live with Parents
Other
If renting please include landlord’s contact info:
*
Do you have a fenced yard?
*
Yes
No
How high is your fence?
*
Number of pet(s) currently living in household- Please include species, gender, age, spayed/neutered, utd on vaccinations, and if current on monthly flea/tick and Heart worm preventation
*
Number of hours (average) pet(s) spends alone
*
Where will the dog(s) stay (be confined) while you are out?
*
How do you discipline your pet(s) and why?
*
Do you have a regular veterinarian?
*
Yes
No
Veterinarian’s Name
*
Clinic Name
*
Clinic's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vet’s Telephone
*
Format: (000) 000-0000.
Please add at least two references and please indicate name, relationship, and contact number. We prefer both NOT to be relatives.
*
I confirm that all information supplied above is correct and accurate. Admission of false or inaccurate information will result in immediate forfeiture of dog to Robbins Rescue Ranch, Inc.
Signature
Submit
Submit
Should be Empty: