Canine Caravan Rescue Inc.

Canine Caravan Rescue Inc.

Adoption Application
Name of dog you wish to adopt
Date

MonthDayYear
Date
Name of applicant assuming responsibility for the care of the dog

First NameLast Name
Age of applicant
Name of co-applicant if applicable

First NameLast Name
Age of co-applicant
Relationship

SpouseLife PartnerFianceSignificant OtherRoommateChild
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Email
example@example.com
Current occupation and employer of primary applicant:
Current occupation and employer of co-applicant:
Canine Caravan Rescue Inc requires that all applicants who wish to adopt one of our animals participate in a screening process that includes a home visit. What is the best day and time to contact you?
Why do you want to adopt a dog? Check all that apply:

Family petI want my child to learn responsibility and a pet is a good learning experienceChild’s petHunting DogGiftGuard DogCompanionCompanion for current petOther
Current Living Situation
Do you live in a

HouseCondo/TownhomeApartmentMobile Home
Do you

Rent/LeaseOwn
If you rent/lease please provide the name and number of your landlord
Do you have your landlord’s approval to have pets?

YesNo
What is the pet deposit?
Are there any breed or weight restrictions?

YesNoIm not sure
If yes, what are they?
How long have you lived at your current address?
Is there a fenced yard?

YesNo
If yes, please indicate type of fence (height, style, etc.)
Are you planning on moving within the next two years?

YesNo
If yes, please explain:
How will you provide exercise for your new pet?
How many adults are living in your home?
How many children? Ages?
If you do not have children, do you have children that visit your home?

YesNo
What are the ages of visiting children?
Does everyone in the family know that you are considering adopting a dog?

YesNo
Is there anyone in your home with pet allergies?

YesNo
Does anyone in your home smoke?

YesNo
Do you foresee any major changes in your life in the next 15 years (average life span of a dog) such as marriage, children, health problems, going away to college? If yes, please explain:
Pet History
Do you currently have a pet?

YesNo
If you responded “yes” to the question above, please describe the pet’s current circumstances and temperament:
If more than one pet, please write information on separate lines.
If you do not currently have pets but have had them in the past (as an adult), please indicate the species, breed (if applicable), sex and age of your former pets. Please explain what happened to your former pets and why they are no longer with you:
Have you ever had a serious behavior problem with a previous pet?

YesNo
If yes, please describe and explain outcome:
Are current/previous pets spayed/neutered?

YesNoOther
How do you feel about spaying/neutering your pet?
Has a dog died on your premises of distemper, parvo or unknown causes?

YesNo
Will this be your first dog?

YesNo
Have you ever tried to adopt from another rescue group or humane society?

YesNo
If yes, from what group and what was the outcome?
Pet Care Philosophy
What type of collar do you/have you used on your dog?
What kind of preventative medical care do you/will you provide for your dog?
Are you familiar with heartworm disease?

YesNo
What heartworm preventative do you/will you use?
What brand flea preventative do you/will you use?
What brand of dog food do you use now or will you use with the new dog?
What would you consider a realistic cost to properly care for a dog for one year?
What is your vet’s name and number? Or the name and number of a vet you plan to use:
Are your current animals up to date on vaccines?

YesNo
Daily Routine
Approximately how long will the new dog be alone during the day?
Where does your current or where did your past dog stay during the day when you are gone?

Goes to work with meOutside in a fenced areaOutside in a dog penOutside on a chain or stakeIn a crate indoorsIn the basementIn the garageBaby gated in one-two roomsFree run of the houseIndoor/Outdoor (has access to the yard via a doggy door)Other
Where will the new dog stay when you are gone during the day?

Goes to work with meOutside in a fenced areaOutside in a dog penOutside on a chain or stakeIn a crate indoorsIn the basementIn the garageBaby gated in one-two roomsFree run of the houseIndoor/Outdoor (has access to the yard via a doggy door)Other
Will your dog be allowed on the furniture?

YesNoCertain pieces
Where does your current or where did your past dog sleep at night?

In a crate in the bedroomYour bedDoghouse in fenced areaDoghouse with tie-outBasementGarageFree run of the houseOne room in houseOther
Where will your new dog sleep at night?

In a crate in the bedroomYour bedDoghouse in fenced areaDoghouse with tie-outBasementGarageFree run of the houseOne room in houseOther
What percentage of time will the new dog stay in the house?
Where will the dog stay when you go out of town?
Are you aware of state and local ordinances concerning pet licensing and leashing?

YesNo
I would allow my dog off leash in the following situations:

In a quiet subdivisionOn unfenced property with a lot of acreageAt the beachInvisible or electric fenceWhen I know that she/he is trained to stay within the set boundariesNeverOther
House Breaking & Training
What type of house training methods will you use?
Do you have any experience crate training a dog?

YesNo
If you don’t have a crate, will you be willing to purchase one if the new dog needs to be crated?

YesNo
Will you enroll this pet in obedience training?

YesNoOther
How would you handle adjustment/training problems such as jumping on furniture?
How would you handle adjustment/training problems such as jumping on people?
How would you handle adjustment/training problems such as excessive barking?
How would you handle adjustment/training problems such as chewing?
How would you handle adjustment/training problems such as house soiling?
Special Circumstances
What circumstances are acceptable to find your dog another home? Check all that apply:

MovingNew baby, no time for dogNot getting along with other petsDivorceGetting out of fenceBehavior problemsSheddingChildren not helping to care for dogIncreased work hoursAllergiesNot housebrokenDog medical problemsHuman medical problemsExcessive barkingGets too bigNot getting along with childrenAggressiveWant to travelNot enough time for the dogNoneOther
Please explain any options that you checked above:
Have you ever given a pet up? If yes, explain the circumstances
Some dogs may develop a frequent urination problem, particularly as they age. If this happens to your pet, how would you address this issue?
What could you realistically afford (add dollar amount) if your dog became seriously ill (e.g. cancer, ruptured disk, etc.)?
If your pet developed a behavioral problem such as aggression, how would you address this?
If you decided to move to another home or were asked to relocate, what options would you investigate for your pet?
How would you respond if a person that you are dating or frequently came over to your house indicated that she/he is uncomfortable around animals?
Most pets require time to adjust to their new home. How much time are you willing to give this pet?
Please provide three personal references (not relatives). May we contact these references?
Please list name and phone number of each reference
Canine Caravan Rescue Inc. reserves the right to refuse any application. We are unable to process an incomplete application.

As stated in our adoption contract, Canine Caravan Rescue Inc. requests that if you decide at any point in time that you are no longer able to keep your pet, that you return the pet to us no questions asked. If you have a relative or friend that wishes to adopt your pet, we ask that they go through our application process. This procedure is mandated by the Georgia Department of Agriculture.

Please understand that this comprehensive process has been developed to protect the animals that are in our care and for us to abide by the regulations governing rescue groups in the state of Georgia. Many of these animals have suffered extreme hardship and have been victims of abuse, neglect or undesirable situations. It is the mission of Canine caravan Rescue Inc. to place these incredible animals in loving permanent homes with animal loving, responsible families.

When you sign below, you are in agreement with our application process.
Signature of primary applicant
Should be Empty: