Adoption Interest Application

Adoption Interest Application

SoCal Animal Rescue Squad
SoCal Animal Rescue Squad (SCARS), is an all-volunteer, non-profit, animal welfare organization dedicated to the rescue and placement of rescued and surrendered animals. The SCARS are completely funded through fundraising efforts and public donations. All of our pets are cared for by foster homes and receive complete medical care, which includes vaccinations, spaying/neutering and microchipping prior to their adoption.

This questionnaire is designed to help The SCARS and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. The SCARS reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions.

Please note that providing false or inaccurate information will result in the dissolution and cancellation of this form/process.
Applicant Information

Thank you in advance for providing us with the following detailed information. We appreciate the time you will dedicate to complete this form. This will help us determine the best fit for you and for our fur-squad-hero (dog). We are committed to helping them find the best possible fit and ensure a happily ever after.
Name of superhero dog you are interested in:*
Your full name:*
Your age:*
Spouse/Significant Other (Full Name):
In the event that this relationship changes, who will the dog stay with?
Street Address:*
City, State, Zip*
How long have you lived at this address?
Home Phone:

Area CodePhone Number
Work Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:*
Employer:
Rate your level of dog owning experience:

First time ownerBeginnerIntermediateAdvancedOther
Tell us why you are looking to adopt?

Companionship for self/spouseCompanionship for other petFor your childrenWatchdogTo giftFor use as Service AnimalOther
Have you ever been denied adoption by a shelter, other rescue, or humane group?
Are you willing to let The SCARS visit your home by appointment?
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?

YesNo
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNoneOther
Is someone home all day? If so, who?
Do you have a fully fenced yard?*

YesNo
Height and type of fence:
What outside areas are available to the dog(s)? (Check all that apply)

Fenced YardBalconyEnclosed PatioDog RunDog HouseGarageOutside KennelDeckPool AreaGrassy AreaOther
How many adults are in your household?*
Do you have a pool?

YesNoOther
If so, is it fenced?

YesNoOther
How many children are in your household?*
If children, what are their ages?
Have your children been around animals before?

YesNo
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
What is your lifestyle like? Active, prefer to stay home, always on the go, athletic, etc...
How is your General Health (health issues)?
*Adopters over the age of 70 are required to have a co-adopter in case of an accident or death. If this applies to you, who would be your co-adopter?
Co-Adopter:

First NameLast Name
Co-Adopter:

Area CodePhone Number
Co-Adopter:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Co-Adopter:
example@example.com
Co-Adopter Age:
Co-Adopter Relationship to you:
Current/Previous Pet Information
List your current pets. Please include age, size, breed and gender?
Are your current pets spayed/neutered?
Are your current pets up to date on their vaccines?
List the pets you've had in the past 5 years that are no longer living. What happened? How old where they?
The ones that you no longer own and ARE living, where are they now? (If applicable)
Have you adopted from an animal welfare group before?

YesNo
If yes, what group?
Have you ever given up a pet?

YesNo
If yes, what were the circumstances?
Have you ever bred an animal?

YesNo
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)*
Will your new pet be a full-time indoor dog?*

YesNoOther
Are there areas in your home that will be off limits to your new pet? And why?
Are you planning to crate your new pet?
Have you ever house-broken a dog or puppy before?*

YesNo
If the dog has an "accident" in your home, what type of correction do you plan to use?*
Are you aware that it can take several weeks for a dog to adjust to its new environment and routine? Are you willing to support them through this transition?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Are you willing to work through your new pet's issues, if any?*

YesNo
How many hours each day will your new pet be home alone?*
Do you plan to take an obedience class with your dog?*

YesNoNot sure
If yes, where?
Where will your new pet stay when nobody is home?*
Will you agree to consult and pay for a trainer or behaviorist if any problems develop?

YesNoOther
Where will your new pet stay when you go on vacation or on an overnight trip?
Where will your new pet sleep at night?*
Will your new pet be allowed on furniture?
Will the dog be left outside at any given time?
How will you supervise the dog's outdoor activity?*
Do you have a doggie door?
Do you understand that a dog can be an 18 year commitment, and there are costs associated with its care?*

YesNo
Are you willing to live with hair on the furniture, stains on your rugs, a warm body on your bed, and an animal that might be destructive at times?
What would you do if your other pets do not acclimate to your new pet?
What circumstances would lead you to give up your new dog?*
Grooming, Veterinarian and Care
Please provide the name and phone number of your current and/or previous veterinarian or clinic:
Do you agree to provide annual vaccinations and any necessary medical care?
If your dog(s) needed acute medical attention for an illness or emergency care, are you prepared to handle the expense?
Do you plan to professionally groom your new pet? Or will you do all the grooming personally?
What kind of food will you feed your new pet?
How many times do you feed your current pet(s) a day? What's your regimen?
For walking purposes which of these do you use or plan to use: (Check all that apply)

Traditional HarnessNo Choke HarnessRegular CollarChoke CollarRetractable LeashRegular LeashI walk them without a leashOther
We require new adopters to be prepared to purchase a new collar and tag at the time of adoption. Will you prepared to provide it?
What would you do if the dog goes missing or runs from you?
Are you familiar with dog car safety equipment? Dog carrier, Harness and seat belt, etc?
Do you have any of these in hand to safely transport your pet upon adoption? (Check all that apply)

YesNot Yet but will be readyOther
In the event that you move, what will happen to your pet(s)?
If you moved locally:
If you moved out of state:
If you moved out of the country:
Personal References

Please list 2 individuals that are familiar with both you and your pets.
Reference 1 Name:

First NameLast Name
Reference 1 Phone #:

Area CodePhone Number
Reference 2 Name:

First NameLast Name
Reference 2 Phone #:

Area CodePhone Number
How did you find out about The SCARS?*

Adoptapet.comPetfinder.comFacebookFriend/Family MemberOther websitePetSmartInstagramOther
Application Agreement
The information and responses I have provided on this application are truthful and correct.
Initial
I understand that The SCARS will check my references including veterinary and personal.
Initial
I understand that a home visit or submitting this application does not guarantee placement.
Initial
I agree to provide my own collar, leash, harness, tag and have a safe way to transport my new pet in my vehicle at the time of completing the adoption contract.
Initial
I understand that The SCARS reserve the right to refuse adoption to any applicant for any reason. This questionnaire becomes part of the contract.
Initial
I understand there is an adoption donation associated with adoption of a pet from The SCARS and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
Initial
I understand many factors determine which applicant will be matched with a particular pet. If I am not able to adopt a pet at this time, it does not mean that I am not considered a good pet owner or that my home is not acceptable. The goal of The SCARS is to place all animals into homes that will best suit the pet's individual needs.
Initial
I understand that I assume full responsibility for the welfare of this pet from the date of adoption. All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian.
Initial
Please enter date of submission

MonthDayYear
Date
Enter Full Name to confirm interest to adopt

First NameLast Name
By clicking the submit button, I verify all of the above information is true and accurate.
Should be Empty:

Adoption Interest Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information

Grooming, Veterinarian and Care

Personal References

Application Agreement