Scribd
Upload
14 views

Adoption Application New

Adoption

Uploaded by

k2ratty
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
14 views

Adoption Application New

Adoption

Uploaded by

k2ratty
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 5

RESCUE A DOG, INC.

ADOPTION APPLICATION

Full Name (including middle name):_____________________________________

Address: ___________________________________________________________

City: ____________________________ State: _____ Zip code: _____________

Email:_____________________________________________________________

Primary Phone:______________________ Alternate Phone:_________________

Birth date: ________________________

Place of Employment :________________________________________________

Name of the dog that you are interested in: _____________________________

Do you currently live in a:

 House
 Apartment
 Condo
 Other

Do you currently:

 Own
 Rent
 Lease
How long have you lived at your current residence?

If you are not the property owner, we will need to verify your landlord’s current pet policy.

Landlord’s Name: Phone #:

How many adults live in your home?

How many children? Ages?

Does anyone in your household have allergies?

Who will primarily be responsible for the care of this dog?

Which of the following best describes your reasons for wanting this dog?

 Companion
 Search & rescue
 Guard dog
 Agility
 Hunting
 Jogging
 Obedience training
 Walking buddy
 Couch warmer

How many hours will the dog be alone each day?

Where will the dog be kept when no one is home?

Where will the dog be kept at night?

Do you have a fenced yard?

If so, how high is your fence? Type of fence?

If you have other pets, are their vaccinations current?

Are they currently licensed?


Do you have a regular veterinarian?

Name: Phone #:

Under what circumstances would you NOT keep this dog?

Please list all of the pets you have had in the last 7 years including current pets and those you
no longer own:

Species Breed Age Sex Altered? Owned how What happened to him
long? or her?

Please describe the temperament and activity level you are looking for in a dog:

 High energy
 Outdoorsy dog
 Lap dog
 Mellow
 Affectionate
 Quiet
 Guard dog

When it comes to relating to dogs, I tend to be more

 Strict, demanding (dog must learn and follow all commands)


 Moderate (encouraging of good behavior)
 Lenient, wishy-washy, easily coerced by the dog

The noise/activity in my home is usually:

 High
 Medium
 Low
I would enjoy brushing or grooming my dog:

 Rarely
 Occasionally
 Daily
 Weekly
 Monthly

I would prefer a dog that:

 Would enjoy walking with me on leash


 Will exercise him/herself in our yard
 Would enjoy going to the dog park
 Would run, jog or hike with me
 Requires only enough exercise to do his/her business

My ideal dog would:

Bad dog habits that I cannot tolerate are:

Please initial the following:

I understand and agree that Rescue A Dog, Inc. makes no express or implied warranty,
representation or promise to the age, health, breed, habits, disposition or safety of the animal.
I hereby accept the animal as is, assume all risks and responsibilities associated with the
ownership of the Animal, including bites, and I hereby fully and completely release, indemnify
and hold harmless Rescue A Dog, Inc., its directors, officers, volunteers, servants, and
employees from any claim, cause of action or liability of any sort or nature, whether known or
unknown, directly or indirectly arising out of or in connection with the adoption, care or
ownership, maintenance, temperament or condition of the Animal.

I agree in the case I cannot keep the animal, he/she will be returned to Rescue A Dog,
Inc. All monies deposited with RAD with be considered a donation to the rescue and are non-
refundable.

I acknowledge falsification of the above can result in my being denied adoption of an


animal or if animal has been adopted to me, the return of that animal to Rescue A Dog, Inc.
I certify that the above information is true and correct to the best of my knowledge

Signature: Date:

Printed Name:

For Office Only:

Home Visit Completed

References Checked

Vet Records of Current Dog Received

Copy of Photo ID

Adoption Fee Accepted

 Type and amount:

You might also like