LRH Adoption Application

LRH Adoption Application
Dear Potential Adopter,

Thank you very much for your interest in adopting one of our Long Road Home Rescue dogs. Please understand it may take 2-3 business days for one of us to contact you. If you have not been contacted within 4 business days of your application submission, please reach out to us at lrhrescuenc@yahoo.com.
Our Adoption Process:

If you are interested in any of our dogs, please review the adoption requirements, review the available dogs, and contact us.

A tax refundable donation is required for adoption.

STEP 1. Review Adoption Requirements

The Basics
You must not be planning to move within 6 months of adopting your new pet. You must be at least 21 years old.
No one in the house can have allergies to dogs.
No one in the house can have a fear of dogs.
Everyone living in the house must be on board for the adoption.
The house cannot have an electric fence.
We do not adopt to families who plan to take our dogs off leash.
You must be willing to consent to a home check and a follow-up visit.
An adoption fee is required upon adoption.
Got kids or pets in the house already?
Children must be at least 6 years old. We will make some exceptions for children as young as 3 with a proven record of strong dog leadership.
Children cannot be scared or anxious around dogs.
Current pets in the house must be spayed/neutered and up to date on all of their vettings (including shots, flea/tick meds, heartworm preventative).
Current pets should be well-socialized and have little to no behavioral problems.
Do you rent?
You must provide a current copy of your lease.
The lease must clearly state that dogs are accepted on the property.
The lease must show that the dog will not be rejected into the apartment based on breed size or for any other reason based on the landlord’s opinion – rather than vetting paperwork. (If you do not have a lease with your apartment or the lease does not meet the requirements, a signed and dated letter from the landlord will be also accepted.)

STEP 2. Fill out Application and Complete Requirements

- Complete and submit your application.
- Complete an interview and home visit or take photos to share.
- Learn if you have selected the right dog for your lifestyle.

STEP 3. Meet & Greet OR Adoption Trial (Pending Approval)

- Bring your family & a collar/leash to the meet and greet.
- If you have other dogs, make sure to bring them as well.
- Come photo ready because we want to capture the “gotcha” moment.
Dog(s) Name:*
Name of the Dog you are applying for:
Your Name*

First NameLast Name
Co-Adopters Name

First NameLast Name
Email*
example@example.com
Phone Number (Cell)*
Please enter a valid phone number.Format: (000) 000-0000.
Phone Number (Work or Home)
Please enter a valid phone number.Format: (000) 000-0000.
Your Birthdate:*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
When is the best time to reach you? *
Day(s) of the Week and preferred time(s)
Less than 6mos6-12mos1-3yrsMore than 3yrs
YesNo
Employer Name*
If retired, please list "RETIRED"
Employer Address*
If retired, please list N/A
HouseCondoApartmentTownhouseMobile HomeOther
RentOwnOther
YesNoN/A (I own)
If you RENT, please provide your landlord(s) contact information below*
Name, Phone Number, Email Address
OR you may provide a copy of your lease stating pets allowed, here.

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Please list Names and Ages of all adults and/or children living with you:*

Rows	NAME	AGE
1
2
3
4
5
6
7

YesNoOther
Family CompanionGuard Dog/SafetyProtection for the HomeCompanion for KidsCompanion for Current PetGift for Friend/Family Member
YesNo
Do you have any preference to breed, sex, age, size, hair length? If yes, please list:*
If no, please list No Preference
Does anyone in your home have allergies to pets? If yes, please explain:*
If no, please list No

Please list all current animals in your home: *

Rows	Name	Age	Sex	Animal Type	Breed
1.
2.
3.
4.
5.
6.
7.
8.

Are all of the animals (excluding rodents/birds) spayed/neutered? If no, please explain why: *
Have you ever had to get rid of an animal? If yes, please explain why:*
Owned, fostered or otherwise
Do any animals in your home currently have any behavioral problems?*
Examples: dominance issues, toy or food possession with humans or other dogs, guardingbehaviors, bullying, aggression, fearfulness, poorly socialized, not housebroken, etc
What training and behavior modification techniques will you use with your new dog?*
Examples: obedience training, clicker training, hiring a trainer, firm commands, food/toys, e-collar, prong collar, positive reinforcement, yelling and screaming at the dog, leash corrections, doing nothing.
How do you plan to exercise the dog? How often?*
1-2 hours2-4 hours4-6 hours6-9 hours9+ hoursOther
YesNoOther
YesNoYes, if required by the rescueOther
Where will the dog be kept while:
You're in the house.... blanks*
You're out of the house.... blanks*
Where will the dog be kept while:
You have company over.... blanks*
You're sleeping.... blanks*
What will you do with your dog when you go on vacation?*
If you have upcoming vacation plans in next 30 days, please also list here
Who will take care of the dog if you are no longer able to?*
What type of fence do you have on your property, if any? Please list material type and height:*
Ex: wood/panel (privacy), picket, chain link, metal, slatted, stone/brick
YesNoOther
^^ If no, please explain:*
List N/A if fence does completely enclose area
If a pet should need to be separated, within the home, from the other pets due to medical or behavioral reasons, are you able to do so?*
Please provide detailed answer.

Please provide your current/future Veterinarian and any others you have used previously up to 2 years prior:*

Rows	Name	Phone #	Address	Reason You Chose (or are no longer using)
Current / Future
Previous
Previous

Is this your current vet or one you plan to use in future?*
Where and how do you plan to groom this dog?*
Do you plan to use a heartworm preventative? Flea/tick preventative? If so, what brand(s)?*
NoYes
What do you expect to budget annually for this care?*
YesNo
What do you expect to budget annually for ER situations?*
When will you be ready to bring this new dog into your home?*

Please provide three references that we may contact in regards to you adopting a dog (must not live in same household as you): *

Rows	Full Name(s)	Phone Number	Physical Address	Relation to You
1.
2.
3.

YesNo
YesNo
We ask that you provide us photos of your house and backyard. We especially want to see the areas where the dog will be kept and loved. If you prefer to email versus uploading here, please email all photos to lrhrescuenc@yahoo.com

You must submit photos of your yard at minimum for application to be considered valid
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Please and Sign
By signing this form, I/we acknowledge that the information on this form is true and correct. I/we agree to all provisions indicated on this form. I/we understand that any misrepresentation of fact may result in Long Road Home Rescue refusing adoption privileges to me/us. If my/our request for adoption is approved and later Long Road Home Rescue discovers the above information is not true or correct, this application becomes null and void. Because of my breach of contract, Long Road Home Rescue reserves the right to remove the adopted pet from my home, and I will be held responsible for any associated legal costs incurred as part of said reclamation process. In order to ensure the best homes for our rescued pets, we reserve the right to deny any adoption application.
By signing my name here I agree that I have read the above terms.This is considered the same as an electronic signature.*

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LRH Adoption Application

Dear Potential Adopter,