TAL Dog Adoption Application

TAL Dog Adoption Application
Today's Date

MonthDayYear
Pet You Are Interested in Adopting:
Full Name

First NameLast Name
E-mail
Phone Number
Cell Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Occupation
Your Place of Employment:
Work Phone
Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Type of Housing:*

Own HouseRent HouseRent Apartment
If you rent, name of landlord or apartment complex:
Landlord's Phone Number:
If you are a renter, does your landlord have a pet policy?
How many adults live in your household?
How many children live in your household?
Ages of children in household:
Who will be responsible for this pet?
In the event of an emergency, who would care for your dog or what arrangements would you make?
How many hours would the dog be alone during the day
What will be the pets living conditions?

Indoor MostlyOutdoor MostlyOutdoor OnlyNot Sure
What Vet Do You Use?
Vet's Phone Number
What Groomer do you use?
Have You Ever Given a Pet Away (to a shelter, rescue or returned to the breeder), if so, why?
Under what circumstance would you feel you HAVE to give up a dog?
Have you ever had an animal lost or stolen?

YesNo
Have you ever had an animal die as the result of being hit by a car or being poisoned?

YesNo
Have you ever had a pet that gave birth?

YesNo
Do you have a fenced yard?

YesNo
Type and height of fence?
Do you have a doggy door?

YesNo
Do you have a pool?

YesNo
If yes, in-ground or above-ground?

In-GroundAbove-GroundNot Appicable
Do you understand the expense that comes with owning a dog or cat? (Food, supplies, toys, vet care, emergency care, etc.):

YesNo
Are you willing to bring your pet to a vet for yearly exams and vaccinations?

YesNoNot Sure
Do you currently have any pets?

YesNo
Types of Pet(s):
Please List All of Your Current Pets and Ages and IF THEY ARE SPAYED OR NEUTERED:
Were any adopted, if so, at what age:
If your pets were not adopted, where did you get them?
Reason for adopting:
What kind of dog do you prefer?

SmallMediumLargeNo Preference
Energy level preferred:

HighMediumLow
Breeds/Mixes Preferred:
Please List 2 References: (Names, Relationship, Phone Number)
If You Agree to All of the Above, Initial Here
Please read and agree to the following:
ü Thelegally required sterilization is included in the adoption fee; I will contactTAL to arrange for the prepaid sterilization on or before___________________. The appointment isonly paid within the sixth month of the animal’s life or before. Failure to make arrangements within the settime frame can result in additional fees being incurred at my own expense. Failure to have the animal sterilized is aviolation of Texas and Arkansas state law and is a criminal offense punishableas a Class C misdemeanor and a warrant may be issued if you do not comply withthis law. __________
Please read and agree to the following:
I agree to have the animalfully vaccinated each year including rabies, to purchase city tags, ifrequired, monthly preventative for intestinal and heart worms, and to providethe animal with proper care and shelter.
Please read and agree to the following:
By signing this agreement,I understand and agree not to take adoption lightly – this is a commitment thatcould last up to 15 years. I understandthat this is a rescue animal and the complete history prior to coming into rescueis unknown.
Please read and agree to the following:
By signing this agreement, I promise to provide a loving, safe home for this animal.
Please read and agree to the following:
If problems arise, I agree to contact TAL and/or seek assistance in training for our family including our new pet before it reaches a level of major concern.
Please read and agree to the following:
I agree to contact TAL with any questions or problems. Taking this animal to an animal shelter is NOT AN OPTION!
Please read and agree to the following:
If I experience a change in my current situation and am unable to keep this animal, I will find a safe and loving home. If I need help, I will contact TAL.
Please read and agree to the following:
I am committing to this animal for its lifetime.
Please read and agree to the following:
There are no refunds of the adoption fee.
Please read and agree to the following:
I will provide a collar, leash and identification tag with my name and phone number(s) which shall be worn with the rabies tag by the animal at all times. I must get these items before leaving Petsmart on the day the animal is adopted.
Please read and agree to the following:
I understand that this animal has been rescued. I realize that adopting a rescue animal is different than adopting a puppy or kitten from a breeder. It may take extra time and care to provide for this animal and to incorporate it into my home and family.
Please read and agree to the following:
I have read this animal's pet description and medical history. I understand that other than what is listed on the pet information sheet/medical records, there have not been any other treatments or tests run on this pet.
This animal's vaccinations are up to date as of the date of this adoption. The records are included with your adoption paperwork. Once this animal is adopted by the Adopter, this animal's care and control are transferred to the Adopter and TAL is no longer responsible for this animal.

By submission of this application, I/We assert that all statements and answers given in said application are the said truth. Any misrepresentation of the truth in this application will invalidate any subsequent volunteer agreement.
Enter the message as it's shown*
I agree that my typewritten electronic signature will be the same as if I had signed in person.
Should be Empty: