Adoption Application Form

Name of Dog You Wish to Adopt

1. Applicant Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

day/month/year

Occupation

Phone number - Landline

Phone number - Cell phone

Email address

2. Second applicant (if applicable)

If n/a state n/a

Date of Birth

If n/a state n/a

Occupation

If n/a state n/a

Phone Number - Landline

If not applicable put N/A

Phone Number - Cell Phone

If no cell number state N/AFormat: (000) 000-0000.

Email address

Joint annual income (optional)

Please provide your Facebook and Instagram Account Name

Are there children in the home? if yes, please state their names and ages. If none, say no.

If no children in the home please state N/A

Who will have the primary responsibility for this dog?

What are your reasons for wanting this dog?

If this dog is already matched are you open to another suitable dog match?

How would you describe yourself?

Are there allergies in the family?

Have you had a dog before?

If yes, what happened to them?

If you currently have other dogs, what are their names, breed mix and ages?

Are your dogs spayed/neutered?

Do you own other types of pets?

Are your other pets spayed/neutered?

Are your other pets up-to-date on vaccinations?

Your current pets' disposition and behaviour towards other dogs?

How much will dog food cost monthly?

How much will vet care cost annually?

How much will grooming cost you annually?

How much will dog sitters cost annually?

We strongly recommend adopters obtain pet insurance. What are your thoughts on this?

Do you own or rent your home?

How long have you lived in your current home?

Do you have a yard?

If yes to the above, is it fenced? Please describe fencing. If no, state n/a.

ie fully or partially enclosed, 4 foot chain link fence with 4 ft secure gate, 6 foot wooden fence with 6 foot secure gate, snow fence, 3 foot picket fence, etc.

If you rent, please provide your landlord's information here:

If you do not rent, state n/a

What is your landlord's pet policy?

If you don't rent, state n/a

Have you ever surrendered or given up a pet?

If you answered "yes" to the above question, please provide details

If you answered no, state n/a

How would you describe you/your family's schedule?

Other

How many hours per day will the dog be alone?

Where will the dog stay during the day?

Where will the dog stay at night?

How many hours exercise (per day) will you provide your dog on weekdays?

Realistic assessment please

How many hours exercise (per day) will you provide your dog on weekends?

Realistic assessment please

What form of exercise would you enjoy with your dog?

Will you crate your dog?

If you have to leave town, emergency or planned, where would your dog stay?

Sex

Coat

Age

Size

Issues you are willing to work on:

It is essential that any dog I adopt be:

Check the answer that applies to you

Other

Under what circumstances would you return a dog?

How would you deal with behavioural issues such as barking, chewing, destructive behaviour, bathroom accidents indoors, unruly leash behaviours, etc?

Bad dog habits I can't tolerate are:

Veterinarian Name and Contact Information (please give them permission to speak to us, as we will be calling them for a reference)

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Reference #1

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Reference #2

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Reference #3

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?

Why do you think this particular dog will be a good fit?

Is there anything else you would like to tell us about yourself and why you want to adopt this dog?

Do have any other adoption applications in progress? If yes, at what stage are you in the process?

How did you hear of Backstreet Paws?

Backstreet Paws Rescue – Adoption Process & Applicant Agreement

Thank you for your interest in adopting a dog or cat through Backstreet Paws Rescue! We appreciate you opening your heart and home to an animal in need. Our goal is to find loving, safe, and permanent homes where both our animals and their adoptive families can thrive.

Please understand that submitting an application does not guarantee approval for a particular dog or cat. Our team carefully reviews every application and will contact only those applicants we feel may be the best match for the individual animal's needs, personality, and circumstances.

If your application is selected to move forward, we will contact you to arrange a Virtual Home Interview, followed by a Virtual Home Tour. This gives us an opportunity to get to know you and your family, learn more about your home and lifestyle, and help ensure that both you and the animal are a good match.

Please don't be discouraged if you are not selected for the dog or cat you initially applied for. Every animal has unique needs, and not being chosen for one particular animal does not mean you wouldn't be a wonderful adopter for another. We encourage you to keep an open heart, as another dog or cat may be the perfect addition to your family!

By clicking the Submit button, I acknowledge and agree to the following terms and conditions:

1. Adoption Process and Home Assessment I understand and agree to participate in Backstreet Paws Rescue's adoption process, which may include an interview, virtual home tour, reference checks, and any additional assessments deemed necessary by the rescue. These steps are intended to help ensure a successful and lasting match for both the animal and the adoptive family.

2. Reference and Veterinary Checks I authorize Backstreet Paws Rescue to contact my personal references and veterinary clinic as part of the application process. I agree to provide permission for my veterinarian's office to speak with a representative of Backstreet Paws Rescue regarding information relevant to my application.

3. Adoption Fees and Puppy Deposits: I understand that an adoption fee applies to all dogs and cats adopted through Backstreet Paws Rescue.

For all puppies who are too young to be spayed or neutered at the time of adoption, an additional $200 spay/neuter deposit is required in addition to the adoption fee.

Once my puppy is old enough for the procedure, I understand that I have the following two options:

Option 1 – Backstreet Paws Rescue's Partner Veterinarian: I may choose to have my puppy spayed or neutered at one of Backstreet Paws Rescue's designated local veterinary offices. In this case, the $200 deposit will be applied toward the cost of the procedure, and Backstreet Paws Rescue will cover the cost in accordance with its arrangements with the designated veterinary office.

Option 2 – My Own Veterinarian: I may choose to have my puppy spayed or neutered by my own veterinarian. In this case, I will be responsible for paying the veterinary bill upfront. Once Backstreet Paws Rescue receives acceptable veterinary documentation confirming that the procedure has been completed, the $200 deposit will be reimbursed to me.

I understand that it is my responsibility to ensure my puppy or cat is spayed or neutered at the appropriate age, as outlined in the adoption contract, and to provide the necessary veterinary documentation when required.

I also understand that adoption fees help cover the costs associated with rescuing, caring for, vetting, and rehoming animals, allowing Backstreet Paws Rescue to continue helping other homeless dogs and cats in need. The adoption fee is separate from the $200 spay/neuter deposit and is non-refundable.

4. Approval Is Not Guaranteed
I understand that submitting an application does not guarantee approval to adopt a dog or cat from Backstreet Paws Rescue. All applications are reviewed at the rescue's discretion, with the individual animal's needs and best interests being the priority.

5. Finalizing an Adoption
I understand that, if approved, my adoption will not be finalized until I have provided valid photo identification, signed the adoption contract, and paid the applicable adoption fee. I agree to abide by all terms and conditions outlined in the adoption contract.

6. Personal Information and Communications
I consent to Backstreet Paws Rescue collecting and using the personal information I provide for purposes related to processing my adoption application and communicating with me about the rescue's activities, campaigns, fundraising initiatives, and opportunities to support its work. I understand that the rescue may contact me by telephone, email, or mail, subject to applicable privacy requirements and my communication preferences.

7. Cat Welfare and Indoor Safety
I understand and agree that any cat adopted through Backstreet Paws Rescue must remain an indoor-only cat and will never be permitted to roam outdoors freely. If I wish to provide outdoor enrichment, it must be done safely and securely, such as in a fully enclosed catio or on a harness and leash under supervision.

I also understand and agree that declawing is strictly prohibited for any cat adopted through Backstreet Paws Rescue, except where a veterinarian determines that a medically necessary procedure involving the removal of a digit is required for the cat's health. Declawing for convenience or to prevent scratching is not permitted.

I acknowledge that these requirements are intended to protect the cat's health, safety, and overall well-being, and I agree to uphold them for the duration of the cat's life.

8. Accuracy of Information
I confirm that all information provided in my adoption application is true, accurate, and complete to the best of my knowledge. I understand that providing false or misleading information may affect the outcome of my application.

By clicking Submit, I confirm that I have read, understood, and agreed to the above terms and conditions and to the adoption process of Backstreet Paws Rescue.

Date

Signature of Potential Adopter

Adoption Application

Type of Dog You Are Looking For