So MD Animal Rescue: Dog Adoption Application

So MD Animal Rescue

Dog Adoption Application
Submitting this application does not mean you are commiting to a dog, nor does it guarantee you will get that dog. It is simply a tool we use to help both you and us identify a good potential match for your family and lifestyle.

A successful adoption depends on selecting the right dog for your household and a good understanding of the dog's needs and care requirements. Please help us with this process by answering the following questions fully & completely. THANK YOU!
Name of the dog you want to adopt*
Adopter's Name*
First & Last Name
Co-Adopter's Name
First & Last Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Adopter's E-mail*
Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Names and ages of all permanent residents of your home (adults and children)*
Do you currently have any pets?*

YesNo
If you currently have pets, please list them below.
Are your current pets altered and vaccinations up to date?

YesNoWill be within the next 30 days, appointment has been scheduled. (We will call your vet to verify this.)
If your current pets are not altered, please explain why below.
Vet reference (please call your vet and give permission to release information to us)*
Vet name, address & phone number
Two Personal References - Include Phone Numbers: we will be reaching out to your references directly so please give them a heads up that we may be calling. *
Are you planning to move in the within the next 90 days?*

YesNo
When will you be ready to adopt this dog?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Is anyone in your home allergic to dogs?*

YesNo
Does anyone in your home fear dogs?*

YesNo
Are you familiar with dog regulations in your area?*

YesNo
If you answered no to the question above, please contact your town/county/condo assoc and ask them what the regulations are.
I/We live in a*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
Renters, have you contacted your landlord to find out if there's any restrictions on the kind or size of dog you can have?

YesNoNot yet, but I willIt's written in our lease
If you rent, you must show us a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have dogs and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have a dog there and show any restrictions.
Approximate square footage of your home*

Less than 800 square feet800-1,000 square feet1,000-1,500 square feet1,500-2,000 square feetOver 2,000 square feet
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
If vertical fence, what is your fence height?

2' high3' high4' high5' high6' high
Annual Household Income*

Under $20,000$20,000-$30,000$30,001-$50,000$50,001-$70,000$70,001 or higher
Do you work outside the home?*

YesNoOne applicant is home/works from homeWe work different shifts
How many hours per day are you away/how long will the dog be home alone? *
Where will the dog be kept when it’s home alone? *
Where will your dog sleep at night and will they be allowed on furniture?
Will you dog be allowed on the furniture?*

YesNo
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
We will be speaking to all adult residents to confirm everyone is aware of this application process and wants to have a dog added to the family. Please do not submit this application if you are "trying to talk someone into" adopting this dog or think "once they meet the dog, they will want one" or "I'm getting this dog as a surprise birthday present for them." In those scenarios, you are welcome to email us to discuss the dog, but we would like all adults in the home to be involved in that email discussion.
How much do you feel you can reasonably afford and would be willing to spend on your dog per year (for things like veterinary care, licensing, ID tag, food, toys, crate, other supplies, training, pet sitting, etc)? *
Please check all that apply. I want to adopt this dog...*

As a family petTo breed with my dogTo train/use for huntingTo train/use for agilityTo train/use as a therapy dogTo train/use as an assistance dog for the disabledTo use as a guard dogFor a jogging/hiking partnerTo interact with lots of friends/familyAs a gift for a friend, partner, or family memberAs a companion for my dog(s)As a companion for my cat(s)As a companion for my child/children
Please take time to think, be honest with yourself and us when answering this question. What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the dog?*

HousebreakingChewingJumpingPulling on leash during walksCounter surfingObedience trainingFear of menFear of womenFear of childrenMouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training)GrowlingBarkingRough play with my dogHigh activity levelFood/toy aggression/not willing to share with other dogsFood/toy aggression with peopleWhining/cryingCounter surfingBlindnessLimited SightDeafnessSeparation AnxietyDiabetesSpecial DietLong Term MedicationIncontinence / Leaking UrineTaking classes with the dogGets stressed/carsick when riding in vehicleDoesn't know how to climb stairsCan't climb stairs due to age/arthritis/health issuesHeart conditionSkin allergiesFood allergiesTrimming nailsYeast on coat or in earsEar mitesFleasTicksHeartworm preventativeAnnual heartworm/lyme combo testingI will do whatever it takes to help this dog adjust and work with a trainer to help resolve any training needs.Other
What would cause you to return a dog?*
What do you feel is a reasonable amount of time for a dog to adjust to life with you/your family?*
How do you plan to integrate this dog into your family?*
What would you do if at any time during the life of the dog the vet diagnosed the dog with a medical condition requiring treatment?*
What brand of dog food do you plan to feed?*
Do you plan to take formal obedience classes?*

YesNo
Do you have any additional comments, questions or concerns? Anything else you would like us to know to help match you up to a dog?*
I understand that completing this application does not guarantee I will be allowed to adopt a dog, and that the application is a tool to help So MD Animal Rescue determine if this dog and my family are a good fit for each other. I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the adopted dog from my possession. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from So MD Animal Rescue to contact my vet for a reference and also agree to allowing a home visit prior to adopting this dog. If I am approved to adopt a dog, I agree to pay a non-refundable adoption fee and hand sign an adoption contract at the time of adoption.
Please read the above, check this box, sign, and click Submit.*

I/We have read and understand all of the above.
Applicant's Signature*
Co-Applicant's Signature
Signature date*
Feel free to email us with any questions - Smar46@aol.com

Renters: Please send a copy of the pet section of your lease or a landlord pet permission letter to the email address above.

So MD Animal Rescue reserves the right to reject any application based on information obtained during this screening process. Please understand that our primary goal is the health, happiness, and safety of our rescued dogs.
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