Pride Rock Rescue Application
Name
First Name
Last Name
Spouse's Name
First Name
Last Name
Home Phone Number
-
Area Code
Phone Number
Cell Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you lived at this address?
Do you...
RENT
OWN
Other
Do you live in
An apartment
House
Duplex
Condo
What age dog are you interested in adopting?
Puppy
Young Adult
Adult
Senior
Any that is a good fit
What size (when full grown) dog are you interested in adopting?
Extra small
Small
Medium
Large
Any that is a good fit
Name of dog you are seeking to adopt:
If the dog you are applying for has been adopted, may we contact you about others available?
Describe your yard:
I have no yard.
I have a yard, but it is not fenced in.
I have a partially fenced in yard.
I have a fully fenced in yard.
Other
How do you plan to train/discipline your dog?
Why do you want to adopt a dog?
How many hours would the dog be left home a day?
Describe your intended routine with a newly adopted dog as well as who would be responsible for providing care:
What is your experience with dogs and what behaviors are you experienced with? For example: shy, house breaking, separation anxiety
Do you agree to seek professional training should an unexpected behavior occur?
Please list all persons, including ages, living in the home and their experience with dogs.
Does anyone in the home have allergies or asthma? If so, please explain how this would be managed with a pet in the home.
Please list all animals, including species/breeds and ages, living in the home.
Do you agree to a home-visit as part of the adoption screening?
YES
NO
Have you adopted from a rescue organization before? If so, where?
Has anyone in the home been arrested for or convicted of or have pending charges of animal cruelty, animal neglect, domestic violence or any felonies?
Please list 3 personal references including phone numbers
Please list names species of previous pets:
Were they euthanized or rehomed? Please explain:
Name and Number of current and past veterinarians:
Name of person listed on the account:
We understand life can be busy, is it okay to text with initial questions to follow up with your submitted application?
Submit
Should be Empty: