Rescue Dog Adoption Application

Chester’s Corner Rescue Foundation Dog Adoption Application
Chester's Corner Rescue Foundation is an all-volunteer, non-profit, animal welfare organization dedicated to the rescue and placement of stray, neglected and abused animals. Chester's Corner Rescue Foundation is completely funded through fundraising efforts and public donations. All of our pets are cared for by foster homes and/or boarding facilities and receive complete medical care, which includes de-worming, vaccinations, spaying/neutering and microchipping prior to their adoption.
This questionnaire is designed to help Chester's Corner Rescue Foundation and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Chester's Corner Rescue Foundation reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!
Applicant Information
Name of the dog you are interested in:*
Your full name:*
Street Address:*
City, State, Zip*
Home Phone:*

Area CodePhone Number
Work Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:*
Employer:*
Personal reference and phone number:
Household Information
YesNoDon't Know
Who will be the pet's primary caregiver?*
HouseApartmentCondoMobile HomeOther
OwnRent
If rent, provide name and phone number of landlord:*
YesNo
Number of petsSize or weight restrictionsBreed restrictionsNone
YesNo
Height and type of fence*
Underground fenceKennelDog Run
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?
YesNo
YesNo
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages*
How many of these pets are spayed/neutered?*
Where are these animals now?*
YesNo
If yes, what group?
YesNo
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:*
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)*
YesNo
YesNo
If the dog has an "accident" in your home, what type of correction do you plan to use?*
How many hours each day will your new pet be home alone?*
Where will your new pet sleep at night?*
How will you supervise the dog's outdoor activity?*
Where will your new dog stay when nobody is home?*
What length of time will you allow your new pet to adjust to his new home?*
YesNo
YesNo
YesNo
YesNoNot sure
If yes, where?
YesNo
What circumstances would lead you to give up your new dog?*
If you had to give up your dog, what would you do with him/her?*
Please upload a copy of your drivers license

Browse Files

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Adoptapet.comPetfinder.comFacebookFriend/Family MemberOther websiteOther
YesNo
By signing this application I agree to the following:

I am at least 18 years old.

I understand that filling out this application does not guarantee adoption.

I understand that Chester’s Corner Rescue Foundation may conduct a home check (in-person or virtual) as part of the approval process.

I agree to provide proper care, food, shelter, and veterinary care to any animal I adopt.

I understand that all adoptions are subject to approval and that Chester’s Corner Rescue reserves the right to deny any application.

I understand that the adoption fee is non-refundable once the dog is placed in my care.

I certify that all information provided is true and complete to the best of my knowledge.
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Chester’s Corner Rescue Foundation Dog Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information