As part of our protocol to match our dogs with the perfect family for them, we need to get some general information about you and your family.

Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Co-Applicant

First Name

Last Name

Co-Applicant phone

(###)

###

####

Have you ever owned a dog as an adult? *

yes

no

Have you ever sold, given away, returned a dog or surrendered a dog to a shelter? *

Yes

No

Have you ever bred a dog? *

Yes

No

Have you ever had a pet who became lost? *

Yes

No

Have you ever had a pet treated for a disease? *

Yes

No

Have you ever had a pet poisoned? *

Yes

No

Have a ever had a pet killed by a vehicle? *

Yes

No

Are you familiar with heartworm preventative? *

Yes

No

Do you have other pets in the home? *

Yes

No

Living situation *

I own my home

I rent my home

I rent an apartment

I rent a condominium/townhouse

If you rent, is your landlord in agreement with your intent to adopt a dog? *

Yes

No

I don't rent

Are you planning on moving in the near future? *

Yes

No

Does everyone in the household want to adopt a dog? *

Yes

No

Yard *

No yard

Yard with no fence

Yard with invisible fence

Yard with physical fence/gate

If your yard does not have a fence, would you be willing/able to install one? *

Yes

No

Do you have a tie-out or runner for your dog?

Yes

No

Crate training *

We recommend crate training for all new rescues

I plan on crate training

I have not planned on crate training

I have no experience but am willing to learn

Are you willing and financially able to attend obedience classes and/or hire a trainer? *

Yes

No

Do all the adults in the home work full time? *

Yes

No

Have you applied to any other rescue groups? *

Yes

No

Dog preference

Male

Female

Age preference

Puppy

Young Dog (1-4 years)

Middle Age (4-8 years)

Senior Dog (8+ years)

The financial responsibility of caring for a dog is estimated to be between $800-$1,000 per year for general vet care, innoculations, good quality foods, licenses, grooming, etc. Are you prepared for this financial undertaking? *

Yes

No

Do you understand that we request a volunteer conduct a home visit to meet with you and your family? *

Yes

No

It is understood that we reserve the right to remove a dog at any time should we find that the adopter is no longer caring for their rescue dog in a way that we see fit? *

Yes

No