Akron Canine Rescued Angels(ACRA) Adoption Application

Adoption Application

ACRA is a nonprofit, all volunteer organization comprised of members who share a common goal of saving pets in need from local shelters, puppy mills, and local surrenders without bias. ACRA is an all breed canine rescue, at times we do rescue felines in need. We provide caring home based fostering and the service of finding the best match in an adoptive family for each individual pet. ACRA reserves the right to deny taking a dog or cat into rescue for any reason. *** ALL RESIDENT PETS must be up to date(UTD) and have a history of veterinarian visits, vaccines, preventatives, and negative heartworm testing.***
ACRA name of pet you are applying for:
Applicant Full Name

First NameLast Name
Joint Applicant

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
What is your current living situation?

Other
If you rent or lease do you have your landlord's permission to have a pet?
If you rent or lease do you have breed restrictions?
Do you agree to a home visit from an ACRA representative?
If you DO NOT agree to a home visit please explain below.
Please list the days and times all members of the household are available for a home visit.
Please list the names and ages of the adults(over 18 years of age) living in your household.
Are there children in your household?
If yes, please list their ages:
Does anyone in your household have allergies to dogs or other animals? If yes, please describe.
Have you previously owned a dog?
Do you currently have any pets?
Please list all current and deceased pets (type, age, gender, temperament):
If you DO NOT currently have pets please choose one of the following:
Do you have a regular veterinarian for your pet(s)?
Have you called your veterinarian to give them permission to speak to rescue?
Name of Veterinarian Practice
Veterinarian's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Veterinarian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are/ Were all of your pets spayed or neutered?
Do all of your current pets have a history of seeing a veterinarian regularly?
Are all of your current pets on Flea/Tick prevention?
Are all of your current pets on Heartworm prevention?
Have you ever bred cats or dogs?
Have you ever adopted a cat or dog from a rescue or shelter?
If you have adopted in the past please list the name(s) of the rescue(s) or shelter(s) that you adopted from with an approximate date.
Do you plan to take your new pet to training?
Please describe the type of training you would take your pet to OR tell why you would not go to training.
Do you have a fenced yard? Answering no to this question will not affect your approval for most pets.
If you have a fence, please describe the type of fence and how much of the yard is fenced.
If you DO NOT have a fence, please describe how you will contain your pet while outside.
Approximately how many hours per day(on average) will the pet be left alone?
What will you be doing with the pet when they are left alone?(crate, kennel, etc.)
What routine activities do you plan to do with your pet?
What are your thoughts about and reasons for dog ownership? To you what is a dog's role in a household?
Are you prepared for the financial and time commitments that come with having a pet? Please answer yes or no. Feel free to also elaborate, but it is not necessary.
Do you have a plan for your pet(s) if something happens to you and you are unable to care for him/her/them? If yes, please describe.
If you have a person that will care for their pets in the event that you are unable to please list their name and phone number. By giving us this information you consent to us contacting them to verify this information and to ask for a personal reference.
Is there anything else you would like to tell us about you, your family, home?
I have contacted my veterinarian to give them permission to speak to ACRA. ***Applications will not be processed unless this is complete.***
I have contacted the person/ people that will care for my pet in the event that I am unable to care for it/them to let them know that an ACRA representative may be calling to confirm this information and ask for a personal reference.
I am aware that ACRA is 100% volunteer based. I will be patient as applications are processed and reviewed in a reasonable amount of time. I am fully aware that ACRA is NOT a first come, first served rescue and all pets are placed in a home that best fits their needs.
By signing this application I agree that all statements I have made and information I have provided is true and accurate. If it is found that any statements or information I have made on this form are not true, the adopted animal can be confiscated. I am also aware that there are additional forms to be signed and agreed upon at the time of adoption.
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