Adopt Me!

Applicant Name

First NameLast Name

Co-Applicant Name

First NameLast Name

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Are you 21 years or older?

YesNo

Employment:

Name of Dog you are interested in adopting:

Why do you want to adopt?

How long have you been looking for a pet?

What is it about the dog that appeals to you?

What qualities are you looking for your in an adoptive pet? In other words, describe your ideal dog.

Are you willing to adopt a dog that may prefer to be the only pet in the home? If you do not have any current animals do you plan on having more than one?

Who will be primary caregiver for this dog?

Does anyone in the home have allergies (animals)?

What would you do in the event it was found someone in the home was allergic to your newly adopted dog?

Have you adopted from any other rescue or shelter in the past? If yes, which agency?

Have you ever surrendered a dog to a shelter or rescue?

Are you aware that rescue dogs may require longer periods to adjust to their new home, family and lifestyle, especially those with unknown, neglectful or abusive backgrounds?

YesI need more informationNo

List of people in your household (including children and ages):

Is everyone in the family in agreement with the pet you want to adopt?

If children are in the home, are they willing and able to discuss proper dog etiquette including but not limited to: appropriate dog interactions such as allowing personal space?

YesNoI need more information.N/A

Are you aware of the financial obligation involved in having a dog?

YesNoI need more information

How much are you expecting to spend on your dog per year? (Including but not limited to: routine veterinary care, food, bedding, toys, etc.)

If your pet becomes ill, how much would you be willing to spend? (i.e. 'EMERGENCY FUND')

Are you aware that this dog will require routine vet care including (but not limited to) annual examinations and vaccinations? Are you willing to provide this?

YesNo

Are you aware dogs often times have food and/or environmental allergies requiring special food and daily care? Are you willing to provide this?

YesNo

All Raising Rogue Foster dogs are on high quality, limited ingredient food costing anywhere between $40-$70 per month. Are you willing to keep the dog on this diet upon adoption?

YesNo

If the pet you are adopting is not house trained, what method will you use to help them succeed?

If your application is approved, are you willing to spay or neuter by 6 months of age or agreed upon age with Raising Rogue Director?

YesNoOther

Do you have any dogs and/or cats at home now? (Please list ALL of the following: age, breed, sex and temperament).

Are all current animals spayed/neutered?

YesNoN/A

Are all current animals current on vaccinations, heartworm + flea/tick preventative?

YesNoN/A

As an adult have you ever been a pet owner?

Have you had any other pets in the past five years? If so, what happened to them?

Name of Current Veterinarian and Phone Number:

Housing:

Rent/LeaseOwn

Type:

Name of Landlord and Phone Number/Email (if rent/leasing) *Please note we will contact landlord:

How long have you been at this address?

If you had to move, what would you do with your adopted dog?

Do you intend to keep this animal inside, outside, or both? (Please note this refers to where the dog will live - we understand they will go outside for potty breaks!)

Do you have a fenced in yard?

YesNo

If yes, please explain what type and is the whole yard fenced in?

If there is no fence, please explain how you plan to contain, allow for bathroom breaks, exercise, etc.

Where will your dog sleep at night?

Where will your dog stay while you are gone at work, weekend trips, holiday/vacations?

How many hours per day on average will your dog be left alone?

Are you familiar with animal regulations in your county/city?

YesNo

Are you willing to make a commitment to provide for this dog for its entire life span?

YesNo

Rescue dogs often have an unknown past. RR can not guarantee any temperaments of our rescues. How long do you intend to allow for this dog to adjust to your home/lifestyle? Note: We operate by the rules of 3's: In the first three days, your new pet may be overwhelmed with his new surroundings. He may not eat, or be himself. After three weeks, he’s starting to settle in, feeling more comfortable, and realizing this just might be his home. He lets his guard down and may start showing his real personality for good or not so good. After three months your pet is now comfortable in his home. You have built trust and a true bond.

Additional Comments:

If you are unable to keep this dog for any reason during its lifetime, we require that you contact Raising Rogue. Once a RR dog, always a RR dog.

Personal Reference 1

Phone Number

Area CodePhone Number

Email

example@example.com

Personal Reference 2

Phone Number

Area CodePhone Number

Email

example@example.com

I understand a brief phone or virtual interview will be required prior to the placement of any Raising Rogue dog.

Yes

I understand at least one meet and greet will be required prior to the placement of any Raising Rogue dog.

Yes

I understand that a home visit in person or virtually may be conducted prior to placement of any Raising Rogue dog.

Yes

Full Name of Applicant

First NameLast Name

Signature

Date

MonthDayYear

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