Date:
Name of Adopter(s):
Age(s):
Driver's License #:
Street Address:
City, State, Zip:
E-mail Address:
Can Resq 4 Paws contact you by e-mail for Resq 4 Paws related information?
Home Phone:
Cell Phone:
Primary Adopter Employer:
City:
Work Phone:
Secondary Adopter Employer:
City:
Work Phone:
Best Time to be Contacted:
Which dog are you interested in?
If no specific dog, age/sex/breed?
Do you prefer a non-shedder?
Why do you want to adopt a dog?
Do you consider yourself/family to be active in such a way that would
include a dog?
What dogs/cats do you currently have?
Breed:
Sex: Age:
Spayed/Neutered?
Breed:
Sex: Age:
Spayed/Neutered?
Breed:
Sex: Age:
Spayed/Neutered?
Breed:
Sex: Age:
Spayed/Neutered?
What happened to your animal:
If you don't have a dog/cat now, what dogs/cats have you owned in your adult
life?
Breed:
Sex: Age:
Spayed/Neutered?
Breed:
Sex: Age:
Spayed/Neutered?
How do your dogs/cats get along with others?
Ever train in obedience?
What discipline method do you use (how to you correct your dog(s)?
Willing to train in obedience?
What dog food do you use?
How often?
Do you use heartworm preventative?
What kind?
Have you ever bred a litter?
Have you ever adopted/rescued a dog/cat before?
From who (names and numbers):
Have you ever returned a dog to a shelter?
If yes, please explain:
Name of veterinarian:
Telephone:
Address:
Personal reference #1:
Telephone:
Address:
Personal reference #2:
Telephone:
Address:
Size of yard:
Completely fenced? Fence height:
Type of fence:
If you do not have a fence, how will the dog be let in and out?
Do you have a dog kennel? What type?
What kind of accommodations do you have for the dog in hot/cold weather?
Is anyone home during the day?
How many hours with the dog be left alone?
Where will it stay?
Do you own. or have you used a crate?
What are the ages of children in contact with the dog?
Please describe any neighbors the dog would be in contact with (do they like
dogs, have children (ages), have dogs, cats)?
Is there asthma or allergies in the household to dogs/cats?
If yes, how severe?
Do you own or rent?
If you rent, a letter of permission from your landlord will be required
prior to adoption.
Name of Landlord:
Address:
City, State, Zip:
Landlord's Phone:
How long at address?
Type of home:
Are there any pet restrictions?
Are you willing to have a Resq 4 Paws member visit your home before and
after the adoption?
Do all parties in the household want a dog?
Adopted pets need adjustment time, are you willing to give the new dog at
least a one month trial period to ensure proper adjustment?
What would, in your opinion, constitute a reason for not keeping the dog?
We are always in need of temporary homes for our rescue dogs. Would you be
willing to foster a homeless pet if it is compatible with your lifestyle and
other pets?
For how long? Until
placed?
I/We
understand that if we cannot keep the dog it will never be sold, given away,
traded, abandoned, or otherwise disposed of to any person(s), dealer,
retailer, auction, institute or other entity for any reason.
I/We understand the dog MUST be returned to ResQ 4 Paws, no
exceptions. I/We agree that we
will notify a member of ResQ 4 Paws in a timely manner to make arrangements
for the return of the dog. I/We
agree I/we will humanely house and care for the dog until arrangements can
be made with ResQ 4 Paws. If
I/We do not return the dog to ResQ 4 Paws we agree to pay $1000 to ResQ 4
Paws for violation of this contract.
Date:
Primary Adopter:
Secondary Adopter: