ADOPTION APPLICATION

Names/Ages of Children, if any:

Any other occupants in home:

Your home address:

Street:  

City, State:  

Zip Code:  

Your phone number:

Daytime   

Evening  

Your email address:  

1.   Type of dwelling: House   Condo   Apt.   Other

2.   Do you rent or own? Rent     Own  

If renting, do you have your landlord's permission to have a dog?
Yes     No  
Landlord's name and phone number:

3.   What are your primary reasons for wanting a dog?
Companion for you   For your kids Gift   For other pet   Watchdog
Other:

4.   If you have children, please describe their previous experience with dogs:

5.   If your children did not want a dog, would you be interested in adopting one for yourself?

6.   Does anyone in your household have allergies? Yes     No  
If yes, describe:

7.   Do you have a pet now? Yes     No     How many?  
Type of Pet(s) (if dog, list breed) 
Age(s)     Sex(es)  
Other pets?

8.   Are your pet/s spayed/neutered?     Yes   No
Have you ever allowed an animal to breed?   Yes     No  

9.   Is there anybody home during the day? Yes     No  
Who?

10.   When will the dog be inside?
Outside?

11.   About how many hours a day will the dog be left alone?
Where will the dog stay when he/she is home alone?
(please be as specific as possible; i.e., run of the house, a specific room, a crate, etc.)

12.   Where will the dog sleep at night? Dog House Garage
If inside, where exactly? Kitchen Master Bedroom Spare room Laundry room Run of the house
Other If other, or if you have additional comments on where the dog will sleep, please specify:

13.   What rooms are off limits to the dog?

14.   What outside areas are available to the dog? Fenced yard Enclosed patio Garage Balcony Dog house Unfenced common area Other

15.   Do you have a doggie door? Yes     No  

16.   Type of fencing? (Chain link, wood, block wall, etc.)

17.   Height of fence: Highest point   Lowest point  
I have recently inspected my fence and it is in good condition.   No  
The fence is intact on all sides and is at least 5 feet from ground level in all areas.   No  
I promise to inspect my fence thoroughly before the home visit and make necessary repairs for the safety and well being of our new pet.   No  

18.   Are there gates? Yes     No  
  How many gates?     How high?

19.   Is there any type of lock on the gate(s)? Yes     No  
Type of lock (padlock, key, latch, etc.):  

20. If no locks, would you be willing to install them prior to placement should this application be accepted? Yes     No  

21. Who has access to your yard? Gardener Poolman Utility Neighbor
Other If other, please explain:

22. Preferred level of exercise with dog? Couch potato Short walks Vigorous walks Hike or jog regularly

23. When you go on vacation, who will care for the dog? (Friend, kennel, dog sitter, etc)

24. What kind of food will you feed the dog?
Brand of kibble:   Canned:  
Other:  

25. Do you have a regular vet? Yes     No  
Name of vet:   Would you like a referral to a vet?   No  

26. Who will groom and bathe your dog?

27. Would your dog wear a collar? Yes     No   When?  

28. Would you allow your dog to wear a permanent Friends for Animals I.D. tag? Yes     No  

29. How would you rate your level of dog owning experience?
First time owner Beginner Intermediate Advanced
Other:

30. How would you discipline your dog if he or she misbehaved?

31. How would you train this dog? Obedience class Hit with newspaper Firm verbal commands Clicker/hand signals
Other If other, please explain:

32. How do you normally walk your dog? On leash Off leash
When on leash do you normally use: Collar only Choke chain Harness
Other If other, please explain:

33. 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? Yes     No  

34. Pets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, shelter and exercise for your new pet? Yes     No  

35. Are you able to make a long-term commitment to care for you pet for its entire life span, which could be as much as 10 to 20 years? Yes     No  

36. What would happen to your pets if you moved?
Locally?
Out of State?
Out of the Country?

37. Which of the following reasons might prompt you to give up your dog? (Check all that apply)
  Excessive barking   Biting   Digging   Moving   Divorce   Poor watchdog   Destructive chewing   Financial Problems   Occasional accidents indoors   Growling at guests   Excessive vet bills   Shedding   Allergies   New spouse/partner doesn't like dog     Aggressive on leash None of the above
Comments:

38. Please list pets you have owned since you have been an adult and the length of ownership; if they are no longer with you, please provide an explanation:

39. How did you find out about our adoption program?
Why are you interested in adopting from a rescue?

Please read and initial each statement below.

I understand that a home visit is required prior to final placement.

I understand that a home visit does not guarantee placement.

I CAN make a donation of at least $250 to help rescue, provide medical care, spay and neuter, board and place other abandoned dogs. (Inability to make a donation does not disqualify an applicant from consideration.) I understand that any donation or contribution is a gift freely given, not a purchase price for a dog.

I CAN NOT make a donation of at least $200 to help rescue, provide medical care, spay and neuter, board and place other abandoned dogs. (Inability to make a donation does not disqualify an applicant from consideration.) I understand that any donation or contribution is a gift freely given, not a purchase price for a dog.

I agree to provide my own collar, leash, choke chain or harness, and personal ID at the time of completing the adoption contract.

Downtown Dog Rescue reserves the right to refuse adoption to any applicant for any reason. This questionnaire becomes part of our contract.

Please list the name of the dog you're interested in again, and tell us why you're interested in this particular dog.

THANK YOU! Please press SUBMIT to send us this form; we will try to get back to you within 24 hours. Be sure to press SUBMIT only once! When you have successfully submitted this form you will be sent to a "Thank You" page.