Dog Adoption App

Dog Adoption Application
We are very small, in home foster based 501C3 rescue. We generally set upmeet and greets in public locations, unless a specific foster home is willing to allow an in home visit. We respect the privacy of all our foster parents. Our rescue runs SOLEY on adoption fees, so while our adoption fees may seem high to some, it is our only way to offset our veterinary expenses.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long at this address?:
Are you planning on moving within the next 6 months?
If yes, what are your plans for your pets if you move?
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Name of Employer:
Work Phone Number

Area CodePhone Number
Up until what time of night can we contact you via phone?
E-mail
Are you 18 years of age or older?
Birth Date

MonthDayYear
If you are over 65 what are your plans for your new dog if you can no longer care for it?
Do you own your own home?
If no, name and phone # of landlord:
Type of Dwelling:
Name and age of ALL occupants in household (including yourself):
If no children, do you plan on having children or will children be visiting the household frequently?
What is your reason for wanting to adopt a dog?
If other, please explain:
How many total hours will your new pet be left alone during the day?
How many total hours will your new dog be outside alone during the day?
If adopting a puppy, where would the puppy be kept when alone?
Do you have a fenced yard?
If yes, which type of fence?
If yes, how tall is your fence?:
Do you have locks and/or latches on all your gates?
Will your adopted dog or do your current dogs be put on a tie out?
Are any members of your household allergic to animals?
If yes, please describe:
Who will have chief responsibility for the care of your new pet?
Over the past 5 years, how many pets have you owned? (Include current pets)
List each individually including breed, age, still living with you? (if not, why?)
Have you and your spouse (if applicable) ever owned a pet together?
If yes, when?
Have you ever lost or given away a pet?
If you currently own a dog or cat, how does he/she react to new pets?
Are your present pets up-to-date on their annual vaccines?
If no, please explain:
Are your present pets spayed or neutered?
If no, please explain.
Were your previous pets spayed or neutered?
If no, please explain.
How much are you financially prepared to spend for routine/emergency medical care, licensing, etc?
What plans do you have for your new pet when you are on vacation?
Which dog(s) are you interested in?
Age of dog you would consider adopting: (check all that apply)
Can/Will you provide your dog with monthly heart worm/flea/tick prevention?
Who is your current or most recent veterinarian? Please provide their NAME and PHONE NUMBER:
If your dog displays behavioral problems (such as jumping on people,excessive barking, potty accidents, etc.) how would you go about correcting the behavior?
If other, please explain:
What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?
If other, please explain:
Is your entire immediate family in agreement with the decision to bring a new pet into your home?
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 15 - 20 years (average life span)?
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?
If yes, please describe:
Have you ever adopted or tried to adopt a pet from us before? If yes, fill out info below.
Pet’s Information

Pet’s NameCat or Dog?Adoption/Application Date
Where will your dog spend most of his/her time?
If you selected outdoor, would your dog be supervised?
Where will your dog eat?
Where will your dog sleep?
If you are traveling more than one hour to adopt your new pet would you be able to pick up in a timely manner? And can you explain how you would accomplish this.
Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.
Reference #1
First and Last Name & Relationship to Self
Reference # 1 Phone Number

Area CodePhone Number
Reference #2
First and Last Name & Relationship to Self
Reference #2 Phone Number

Area CodePhone Number
If there is anything else you think we should know, please note it here.
Please initial the following boxes
-Do you understand and agree that all rescue dogs need a MINIMUM of 3 weeksto acclimate and settle into a new home?
-Do you understand and agree to slow introductions to resident pets
-Do you understand and agree that while NDCB makes every attempt to uncoverand disclose any behavioral issues, rescue dogs can develop and exhibit newissues in a new home that may require the use of a professional trainer? Do youagree to hire and utilize a professional dog trainer should the needarise?
Do you understand and agree that while NDCB makes every attempt to uncover,disclose and treat all medical issues, new medical issues can arise and mayneed the treatment of a licensed veterinarian and or specialist? Do you agree to utilize a veterinarian and or specialist should the need arise?
Do you understand and agree that all adoption fees are non refundable oncepaid to NDCB
Do you understand and agree that if at any time , you cannot keep your adopteddog, it must be returned to NDCB at your expense?
Do you understand and agree that all NDCB dogs are to be kept indoors, asloved family members? We strictly prohibit the use of chains, tethers, outdoorkennels, and outside only dogs. Do you agree to this ?
Do you understand and agree that while NDCB will adopt to out town and out ofstate adopters, all transport costs are the sole responsibility of the adopter?
Do you understand that we cannot hold dogs at all. Available dogs will remain availableand able to meet approved adopters until an adoption contract is signed and the adoptionfee is paid.
Please remember, it may take approximately 2 to 3 business days for us to get back to you.
Thank you so much for wanting to rescue a dog!!
Should be Empty:

Dog Adoption Application

Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.

Please initial the following boxes

Please remember, it may take approximately 2 to 3 business days for us to get back to you.

Thank you so much for wanting to rescue a dog!!