LAKE ERIE LABRADOR RETRIEVER RESCUE, INC. A 501(c)(3) Organization Adoption Application

Name of dog you are interested in: *

Why are you interested in this Lab? *

Name of applicant: *

Address *

Street Address
Street Address Line 2
City	State
Zip Code	Country

Phone (home): *

Phone (cell): *

Phone (work):

Email *

What is your preferred method of contact for questions?

Email Phone Text

Do you have a driver's license? *

Yes No

If the answer is yes, which state is your driver's license issued under?

Are you employed? *

Yes No

Occupation? *

Spouse / partner employed? *

Yes No n/a

Occupation? *

Name, age and relationship of everyone living in this home (including the applicant): *

Have you or anyone else in the household ever been convicted of a felony? If yes, please explain. *

Yes No

Details of Felony. *

Does anyone who resides in your home suffer from allergies to animals? *

Yes No

Is everyone in the house in agreement about getting a Labrador? *

Yes No

Do you live in a: *

House Apartment Duplex Condo

Do you (the applicant) own this property? *

Yes No

If renting, does your landlord/rental agency allow dogs over 40#?

Yes No

Please provide your landlord’s name and phone #.

How long have you been at your current residence? *

Do you anticipate moving in the next 6 months? *

Yes No

Is all, or part, of your yard completely fenced? *

Yes No

Type of fence and height?

How do you intend to constrain/restrain the dog in your yard if not fenced? (Enter n/a if not applicable)

If you have an invisible fence, please describe your method of training a new dog to that fence.

Where will the dog spend the majority of its time when you are home? *

Describe what type of neighborhood you live in (city street, suburb, rural, etc) : *

How much vehicle traffic is there on your street? *

What equipment and accommodations do you have for a dog (size of yard, crate, dog run, dog bed, etc).: *

What animals do you own now (please list all by name, include age, what type of animal it is and whether it is an inside or outside pet): *

Where did you get each animal from? How long did you own each animal? Is/was it spayed/neutered?

Please list by name any pets that you have had in the last 3 years that you no longer have, and for each, indicate why you no longer have them and where they are now. *

Have you ever sold, given away, or taken a previous pet to a shelter/pound? If so, why? *

Any new dog needs time to adjust to a new environment. How long do you feel is a fair amount of time for the dog to fit into your new home/family/lifestyle? *

Are there any circumstances under which you would consider not keeping a dog and returning it to the rescue? *

Who will be financially responsible for the veterinary care, feeding, and grooming expenses for this pet? *

We will be contacting your vet to verify that you have kept your current/most recent dog up to date with annual vaccinations, annual heartworm testing and year-round use and purchase of heartworm preventive medications. We require documentation showing this from either you or your vet.

Name of veterinarian practice taking care of your current or most recent pets?

Address:

Phone Number:

Length of relationship:

Human name on account:

If you have been with this vet for less than 3 years or you use more than one vet, please provide the contact information for that prior/additional/other vet.

Name of veterinarian practice:

Address:

Phone Number:

Length of relationship:

Human name on account:

Are/were all current/most recent pets up to date on their vaccinations? If not, why not? *

Are you familiar with canine heartworms? *

Yes No

Do/did you use monthly heartworm prevention on your current/most recent dogs? *

Yes No

If yes, what brand?

Where did/do you buy it?

How many months of the year do you administer the heartworm medication?

If no, why not?

Please provide two personal references (these may not be family members):

Name 1: *

Address: *

Phone: *

Nature / length of relationship: *

Name 2: *

Address: *

Phone: *

Nature / length of relationship: *

Note for above question:

Please contact your references to let them know that you have listed them - so they will be expecting a call from a # they are unfamiliar with and that you authorize them to disclose information to our rescue. We will not be able to proceed until we have spoken with both of them.

What is your prior dog owning experience (include non Labradors)? *

Please describe (not list) your prior Labrador experience/s (or exposure, if you have never owned one) - i.e. what kind of personality, what did you enjoy doing with them, what did they love to do, etc. *

Please ask each person in the home what age Labrador retriever they would like and why - list responses here: *

What role(s) will this dog fill for you and your family? Please discuss this in as much detail as possible. For instance, what do you see the dog doing FOR you? WITH you? *

What do you expect, behaviorally, from this dog? *

How many hours will this dog be expected to be alone (without human companionship) on typical days? *

Where will the dog be kept during that time when you are not home (be specific)? *

Where will the dog sleep at night (be specific)? *

If you have children in the home, will this be their first experience with a large dog living in your home? *

Yes No n/a

If yes, what exposure have they had to dogs?

How and where will the dog be cared for when you are on vacation? *

How do you plan to obedience train your dog? *

How do you plan to socialize your dog? *

How did you learn about Lake Erie Labrador Retriever Rescue? *

Have you applied to adopt from any other rescues at this time? *

Yes No

How soon are you looking to adopt?

While every effort has been made to evaluate the dogs we either foster or to which we might refer persons seeking to adopt, we do not guarantee the temperament or physical soundness of any dog that may be placed through the rescue process.

We may require YOU to provide the documentation of veterinary care.

I/we agree that we have read this Application entirely, and that I/we understand the Disclaimer above. I/we agree that the information I/we have provided is complete and accurate. I/we further agree to release and hold harmless Lake Erie Labrador Retriever Rescue, Inc., its Trustees, officers, directors, volunteers, and foster families from any claims, damages, costs, or actions incurred as a result of any adoption through its auspices or caused by the actions of any dog adopted through its auspices. I/We understand that Lake Erie Labrador Retriever Rescue, Inc. will conduct a background check as part of its approval process, and we agree to this. By submitting this application I/we agree to the above terms.

Enter full name: *