Adoption Application Form for Puppy Pals Rescue


 When you complete our application, you will receive a notice to inform you that it is on file. If we need further information, or if you are being strongly considered for one of our dogs, you will be contacted by a member either by telephone or email.
 
All applicants must be at least 21 years of age. Prove responsible as the primary care giver of the dog (including spaying/neutering of current family pets). Have financial stability.  If you rent, we require a letter from your landlord giving you permission to keep a dog on the premises and stating that there are no insurance problems. 
 
Adoption donations are based primarily on the age of the dog and typically range from $100 - $400. The adoption donations help pay for the vet bills incurred while the dog was in our care, usually the bills go far beyond the adoption donations.

Dog Adoption Form
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Which dog are you interested in?
First Name
Last Name
Date of Birth (mm/dd/yy)
Spouse Name
Spouse DoB (mm/dd/yy)
Address
City
State
Zip Code
Home Phone
Cell Phone
e-mail address
Number of children living at home:
Age: 0 - 5
Age: 6 - 12
Age: 13 +
Time at current address (yy/mm)
Current home type (Home/Apartment/Condo)
Do you Own or Rent
Local environment (City/Suburb/Rural)
Yard Fenced? (Yes/No)
Type of fence
Fence Height (ft)
Gate padlock secured? (Yes/No)
Is someone home during the day? (Yes/No)
If no, where will the dog stay?
Will you take the dog to obedience classes if needed? (Yes/No)
What gender dog are you looking for?
Age preference
Why do you want a dog?
Under what circumstance would you give up your dog?
What animals do you currently have?
Are your pets current on vaccinations? (Yes/No)
Are your pets spayed/neutered? (Yes/No)
Are your pets on Heartworm and Flea prevention? (Yes/No)
What brands?
Your Vet's Name and Address
Your Vet's Phone No.
Is it okay if we call your vet? (Yes/No)
What name are the animals under at the Vet?
Date of pets last vet visit (mm/dd/yy)
Pets owned in the last 10 years
If no longer with you, where are they?
How did you hear about Puppy Pals Rescue?
Is there any problem taking an adopted dog to the vet within 2 weeks? (Yes/No)
You understand that our dogs pasts are unknown (Yes/No)
Are you willing to work with us to correct problems? (Yes/No)
Reference 1 (name, address and contact number)
Ref. 1 e-mail address
Reference 2 (name, address and contact number)
Ref. 2 e-mail address
Reference 3 (name, address and contact number)
Ref. 3 e-mail address
Additional Comments
I have read and accept the disclosure below (Agree/Disagree)

Disclosure

Please note we are not looking to "get rid of" or "find a fast home" for our fosters. We are looking for the best possible home for each and everyone of our dogs, so while you might provide a good and loving home for one, the foster parent might find another application that fits the needs of that particular dog better. There will most likely be another dog that will fit into your home and family better. The dogs are evaluated and their needs assessed before we make any effort to place them.
 
I understand that I am not guaranteed a dog by filling out an application. I officially state that the information provided on this application is true and correct.