Application Form

APPLICATION FORM

Applying to

Please indicate the age of the dog you are looking for. (the applicable adoption fees are shown). All adoptions include up-to-date (for age) vaccinations, desexing, and microchipping.

Name of the dog you wish to adopt. If you are interested in more than 1 dog please list all dogs.

Enter 'Not Chosen' if a specific dog is not applied for

If this dog is already matched are you open to another suitable dog?

What are your reasons for wanting this dog?

Name of Primary Applicant

First NameLast Name

Date of Birth

Occupation

Phone Number

Format: (000) 000-0000.

Phone Number Type

Phone Number

Format: (000) 000-0000.

Phone Number Type

Email

Please provide your Facebook or Instagram name

Home Address

Street Address

Street Address Line 2

CityProvince/State

Postal/Zip Code

Name of Secondary Applicant

First NameLast Name

Date of Birth

Occupation

Phone Number

Format: (000) 000-0000.

Phone Number Type

Phone Number

Format: (000) 000-0000.

Phone Number Type

Email

Please provide your Facebook or Instagram name

Joint annual income

Do you own or rent your home?

How long have you lived in your home?

If you rent your home, who is your landlord and what is the pet policy?

Do you have a fenced in yard?

How high is the fence

ie: fully or partially enclosed, 4 foot chain link fence with 4 foot secure gate, 6 foot wooden fence with 6 foot secure gate, snow fence, 3 foot picket fence, etc. If sides are different please explain. Include sides without fencing but with vegetation.

Please list all people living in the home. Please include yourself and the names, relationship to you, genders, and ages of everyone else.

How would you describe your homes activity level?

How would you describe yourself?

How would you describe your schedule?

Are there allergies to animals in the family?

If Yes, please specify

Have you previously had a dog that is no longer with you?

If yes, please explain what happened to them

Have you ever rehomed or surrendered a dog?

If yes, please explain the circumstances that lead to the rehoming/surrendering

Please list all animals in the home, including their names, species, gender, and ages

Are your animals spayed/neutered?

If no, please explain why the animal is not spayed/neutered

Are your animals up-to-date on vaccinations?

If no, please explain why is the animal not up-to-date on vaccinations

If your current pet is a dog, where does it stay while you are out?

What is your current pets' disposition and behaviour towards dogs?

Estimate how much dog food will cost monthly?

Estimate how much vet care will cost annually?

Estimate how much grooming will cost annually?

Estimate how much dog sitters will cost annually?

We strongly recommend adopters obtain pet insurance. What are your thoughts on this?

How many hours per day will the dog be alone?

Where will the dog stay during the day?

Where will the dog stay during the night?

How many hours of exercise will you provide the dog daily?

What types of exercise would you enjoy with your dog?

Are you willing to use a crate for the dog?

If you have to leave town, emergency or planned, where would your dog stay?

What gender of dog are you looking for?

What age of dog are you looking for?

What size of dog are you looking for?

What type of coat are you looking for?

Issues you are willing to work on

It is essential that any dog I adopt be:

Under what circumstance would you return the dog to Death Row Dog Rescue?

Check the answer(s) that apply

Other

Describe bad habits you can not tolerate are:

Enter NA if not applicable

Have you ever fostered a dog before?

If yes, please describe your experience.

Please check all that apply

Is there anything you would like to tell us about yourself and why you want to adopt this specific dog?

Do you have any other adoption applications in progress? If yes, with whom and at what stage are you in the process?

Do you have a regular veterinarian? (If yes, PLEASE CALL YOUR VET AND GIVE THEM PERMISSION TO SPEAK WITH US as we will be calling them for a reference.)

Vet's Name

Clinic Name

Clinic Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Clinic Address

Street Address

Street Address Line 2

CityProvince/State

Postal/Zip Code

Please provide three personal references. We would prefer 2 non-relatives if possible)

Clinic's Telephone

Format: (000) 000-0000.

How did you hear of Death Row Dog Rescue?

By clicking the Submit button, I agree to Death Row Dog Rescues (DRDR) adoption process and understand a video home check and interview at the discretion of DRDR will be conducted.
By clicking the Submit button, I understand DRDR will check my personal and veterinary references, and agree that I will call my veterinarian's office to give permission for their representative to speak with DRDR.
By clicking the Submit button, I understand there is an adoption fee associated with the adoption of a dog from DRDR. I understand all adoption fees are non-refundable.
By clicking the Submit button, I understand there is no guarantee that I will be approved to adopt a dog from DRDR.
By clicking the Submit button, I agree that, if I am approved for a dog from DRDR, I must provide photo ID and sign a contract.
By clicking the Submit button, I acknowledge that all dogs remain the property of DRDR until photo ID, the contract, and all adoption fees are paid.
By clicking the Submit button, I verify all the above information is true and accurate.

Signature

Date