ADOPT-A-RESCUED-PET, INC ADOPTION APPLICATION

Name

Street Address

City

ZIP

Daytime Phone

Evening Phone

E-mail

How long at this address?

If less than 3yr, previous address

untitled element

Do you own or rent? If you rent, a statement from the landlord with address and phone number is required. Own Rent

Does anyone in your household have allergies to dogs or cats? Yes No

Children in the family? Yes No

How many?

What Ages?

Occupation?

Place of employment

Employer’s phone

Would you consent to a pre-adoption and post-adoption home visit? Yes No

What pets have you owned before?

What happened to them?

What animals do you own now?

Spayed/neutered? Yes No

Do your pets tolerate other animals?

Your veterinarian office?

Are you financially prepared to provide the necessary care for your pet including: proper food, vaccinations, parasite control (fleas, ticks, worms, etc.), licensing, adequate shelter, and veterinary care for yearly check-ups, or an after-hours medical em Yes No

Will your pet spend all or most of the daytime indoors?

At night? Yes No

Are you willing to COMMIT yourself and your energies to this pet for its lifetime? Yes No

What do you consider a good reason to give up your pet?

Have you ever used a crate to train a pet? Yes No

Any objection to doing so if needed, i.e. to prevent unwanted behavior [chewing electric cords, furniture]; or health problems that might occur; for further house breaking of a shelter pet; to medicate urinary tract infection, etc.) Yes No

Is your yard fenced “dog secure”? Yes No

If not, how will you “potty” your dog?

Will outside shelter be needed/available while you are away for short periods?

Have you trained a dog in basic obedience in the past? Yes No

If needed for better control, would you be willing to take your dog through a basic obedience class? Yes No

I am interested in the following type, breed, age, size, and animal

About how many daytime hours, per day, will you be able to be at home with your pet?

I agree to allow Adopt-A-Rescued Pet, Inc. to do a home visit prior to adoption, and as a follow up, if needed, to investigate the premises where the animal is kept, and to reclaim the animal, if in the judgment of Adopt -A- Rescued Pet, Inc, the animal is not being adequately cared for, the terms and conditions of this adoption contract have not