Name of Animal Applying For
Name
*
Applicant's Full Name
First Name
Last Name
Co-Applicant (if any)
First Name
Last Name
Age of Applicant(s)
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Home Phone
(###)
###
####
Cell Phone
(###)
###
####
Other Phone
(###)
###
####
Occupation
*
Employer
Co-Applicant's Occupation
Co-Applicant's Employer
Do You (or, Co-Applicant) Work from Home?
Do You (or Co-Applicant) Attend School?
Why Do You Want to Bring a Pet Into Your Home?
Please describe why you feel your home would be the best home for this particular animal.
How Long Have You Been Looking for a Pet?
Is Everyone in Your Household in Agreement About Adoption a Pet?
Who Will be Primarily Responsibe for the Grooming, Housebreaking and Training of this Pet?
Is the Pet You are Applying for Going to be a Gift?
Names & Ages of Adults in your Household:
Age of Children in your Household:
Does Anyone in your Household Smoke Inside the Home?
Are You Familiar with the Pet Regulations of your Building and Area?
Do You Own or Rent?
Own
Rent
If You Rent, Please Provide Landlord's Name & Phone Number:
Are You Planning to Move in the Near Future?
Please Briefly Describe Your Home:
Where Will Your New Pet be Kept When you are Home During the Day and at Night?
When no one is Home, Where Will the Pet be Kept?
How Many Hours During a Typical Day will the Pet be Left Alone? If More than Four or Five Hours, Can You Arrange for Someone to Walk the Dog While You Are Away?
Do You Have a Yard
YES
NO
If yes, is it Fenced in?
YES
NO
If it's Fenced, How High is it?
If it's not Fenced, How Will Your Pet Relieve/Exercise?
Are There Screens on All Windows?
Should You Become Ill, Disabled or, Should You Die, Who Will Take Care of Your Pet and, What is that Person's Relationship to You?
Name
Address
Phone Number
Please List any Companion Animals Currently Living in THAT PERSON's Household (Breed, Age, Sex, Altered)
Should your adopted pet develop special needs over time, will you still keep this pet, get proper veterinary care and follow your vet's guidelines, including whatever treatments/medications/special foods are required? Do you have the financial means to properly care for the pet? Would you consider buying pet insurance?
YES
NO
Will you assume all financial responsibilities for the pet you adopt including: inoculations, regular veterinary care, good quality food, licensing, ID tag, Dog bed, leash, collar, etc.?
YES
NO
Have You Had Pets in the Past?
YES
NO
How many years did you own your pet?
Reason for no longer owning the pet(s)?
Have your pets ever gotten lost? or Poisoned? or Hit by a vehicle? If yes, explain
Have you ever surrendered a pet to a shelter?
Please list any pets currently residing in your home, together with name(s), breed(s) and age(s)
Please describe pets you've had in the past (including breed, and what training they had) and your history with them
Please provide names, phone numbers and relationship info of two people not related to you
VET REFERENCE (If you have note owned a pet and have no vet reference, please add a third personal reference above)
How did you find out about WOOF! Dog Rescue?