Rescued for Life, Inc. ANIMAL ADOPTION APPLICATION
Phone: 720-278-1880
Email: adopt@rescuedforlife.org
Website: www.rescuedforlife.org

Mailing Address: 16604 E. Kent Dr.
Aurora, CO 80013

* IMPORTANT * Please read the adoption policies and procedures on our website before you fill out this application. Each question on this application must be completed in as much detail as possible. Incomplete applications will not be considered.
STEP 1: APPLICANT INFORMATION
FULL NAME:
Your answer
DOB:
MM
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DD
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YYYY
TODAY'S DATE
MM
/
DD
/
YYYY
MARITAL STATUS:
NAME OF SPOUSE:
Your answer
SPOUSE'S DOB:
MM
/
DD
/
YYYY
HOME STREET ADDRESS:
Your answer
CITY:
Your answer
STATE:
Your answer
ZIP CODE:
Your answer
HOME PHONE NUMBER:
Your answer
CELL PHONE NUMBER:
Your answer
WORK PHONE NUMBER:
Your answer
EMAIL ADDRESS:
Your answer
DOG/PUPPY YOU ARE INTERESTED IN:
Your answer
RESIDENCE (CHECK ONE):
DO YOU OWN OR RENT?
IF YOU RENT, DO YOU HAVE PERMISSION FROM YOUR LANDLORD TO HAVE A DOG?
NAME OF LANDLORD:
Your answer
LANDLORD'S PHONE NUMBER:
Your answer
ARE YOU PLANNING ON MOVING IN THE NEXT YEAR OR SO?
IF YES, WHERE AND WHEN?
Your answer
DO YOU HAVE CHILDREN UNDER THE AGE OF 18 LIVING IN THE HOUSEHOLD?
IF YES, LIST THEIR AGES:
Your answer
IF YOU HAVE CHILDREN, WHAT HAS BEEN THEIR EXPOSURE TO DOGS?
EXCLUDING CHILDREN, SPOUSE, AND APPLICANT, LIST ANY OTHER RESIDENTS LIVING IN THE HOUSEHOLD (NAMES AND RELATION):
Your answer
WHO WILL BE RESPONSIBLE FOR THE DAILY CARE, SUCH AS FEEDING AND EXERCISE?
Your answer
WOULD YOU EXERCISE THE DOG?
IF YES, WHAT FORMS OF EXERCISE WOULD THE DOG RECEIVE?
Required
HOW MANY DAILY WALKS WOULD THE DOG TAKE?
Your answer
HOW LONG WILL EACH DAILY WALK BE?
Your answer
HOW OFTEN WOULD THE DOG RECEIVE EXERCISE?
Your answer
WHAT IS THE ACTIVITY LEVEL OF YOUR HOUSEHOLD?
WILL YOU USE THE DOG TO GO HUNTING?
WILL YOU USE THE DOG AS A WORKING DOG?
WHAT ARE YOUR REASONS FOR ADOPTING A DOG? (CHECK ALL THAT APPLY)
Required
WOULD THIS BE YOUR FIRST DOG?
STEP 2: WHAT HAS BEEN YOUR EXPERIENCE WITH DOGS?
CHECK ALL THAT APPLY
I HAD DOGS GROWING UP:
I HAVE HAD A TOTAL OF: (NUMBER OF DOGS)
Your answer
I AM EXPERIENCED WITH DOGS:
I HAVE ATTENDED TRAINING CLASSES:
PLEASE PROVIDE A DESCRIPTION OF HOW YOU WOULD CORRECT YOUR NEW PUPPY/DOG IF IT SHOWED DESTRUCTIVE OR INAPPROPRIATE BEHAVIOR SUCH AS DIGGING, JUMPING, CHEWING, ETC.
Your answer
ARE YOU WILLING TO PAY FOR AND ATTEND BASIC DOG CARE OBEDIENCE CLASSES?
HOW MUCH DO YOU THINK IT WILL COST TO TAKE CARE OF THIS ANIMAL EACH YEAR? (FOOD, LICENSE, VET BILLS, ETC.)
Your answer
WHAT ACTIVITY LEVEL ARE YOU LOOKING FOR IN A DOG?
DO YOU KNOW IF ANYONE LIVING IN THE HOUSEHOLD IS ALLERGIC TO DOGS?
ARE YOU FINANCIALLY PREPARED FOR EMERGENCY MEDICAL AND/OR MAJOR MEDICAL CARE FOR THE PET?
STEP 3: EMPLOYMENT INFORMATION
WHAT IS YOUR OCCUPATION?
Your answer
WHAT ARE YOUR HOURS?
Your answer
EMPLOYER NAME:
Your answer
SPOUSE'S OCCUPATION:
Your answer
WHAT ARE HER/HIS HOURS?
Your answer
SPOUSE'S EMPLOYER NAME:
Your answer
STEP 4: PET'S HABITAT
HOW MANY HOURS WILL THE DOG BE LEFT ALONE?
Your answer
HOW MANY EVENINGS PER WEEK DO YOU SPEND AT HOME?
Your answer
WHERE WILL THE DOG BE KEPT DURING THE DAY WHEN AT WORK AND/OR AWAY FOR THE DAY?
Required
HOW MANY HOURS PER DAY WILL THE DOG BE IN A CRATE?
Your answer
HOW MANY HOURS PER DAY WILL THE DOG BE CONFINED TO A SPACE IN THE HOME?
Your answer
WHAT PART OF THE HOME WILL THE DOG BE CONFINED TO?
Your answer
IS YOUR YARD COMPLETELY FENCED?
IF YES, WHAT TYPE OF FENCE, AND WHAT HEIGHT IS THE FENCE?
Your answer
STEP 5: PET HISTORY
LIST ALL OF THE DOGS AND/OR CATS YOU HAVE OWNED WITHIN THE PAST YEARS:
PET #1
YES
NO
DOG
CAT
SPAYED/NEUTERED?
MALE
FEMALE
DO YOU STILL HAVE THIS PET?
IF NO, WHAT HAPPENED TO THE PET?
Your answer
WHAT BREED IS THE PET?
Your answer
WHAT AGE IS THE PET?
Your answer
PET #2
YES
NO
DOG
CAT
SPAYED/NEUTERED?
MALE
FEMALE
DO YOU STILL HAVE THIS PET?
IF NO, WHAT HAPPENED TO THE PET?
Your answer
WHAT BREED IS THE PET?
Your answer
WHAT AGE IS THE PET?
Your answer
PET #3
YES
NO
DOG
CAT
SPAYED/NEUTERED?
MALE
FEMALE
DO YOU STILL HAVE THIS PET?
IF NO, WHAT HAPPENED TO THE PET?
Your answer
WHAT BREED IS THE PET?
Your answer
WHAT AGE IS THE PET?
Your answer
PET #4
YES
NO
DOG
CAT
SPAYED/NEUTERED?
MALE
FEMALE
DO YOU STILL HAVE THIS PET?
IF NO, WHAT HAPPENED TO THE PET?
Your answer
WHAT BREED IS THE PET?
Your answer
WHAT AGE IS THE PET?
Your answer
LIST ALL OTHER PETS YOU HAVE HAD IN THE PAST:
Your answer
HAVE YOU EVER SURRENDERED OR GIVEN AWAY A PET?
IF YES, PLEASE EXPLAIN THE REASON:
Your answer
WHERE DO YOU LEAVE YOUR DOG WHEN YOU GO ON VACATION?
Your answer
DO YOU TRAVEL A LOT?
HAVE YOU ADOPTED A DOG THROUGH A SHELTER OR RESCUE BEFORE?
IF YES, NAME OF SHELTER AND/OR RESCUE:
Your answer
HAVE YOUR OWN PETS BEEN INTRODUCED TO OTHER ANIMALS?
IF YES, HOW DID THEY REACT?
DO YOUR OWN PETS RECEIVE VETERINARY CARE?
NAME OF ATTENDING CLINIC:
Your answer
PHONE # OF CLINIC:
Your answer
NAME OF VETERINARIAN:
Your answer
WHOSE NAME IS ON THE ACCOUNT?
Your answer
WILL YOU ALLOW A HOME VISIT TO ENSURE THAT YOUR HOME IS APPROPRIATE FOR THE DOG?
HAVE YOU READ OUR ADOPTION POLICY AND PROCEDURE ON THE WEBSITE? IF NO, PLEASE READ THE ADOPTION POLICY AND PROCEDURE BEFORE SUBMITTING THIS FORM. THANK YOU!!
WHAT DAYS AND TIMES WOULD BE GOOD FOR YOU TO DO A MEET AND GREET?
Your answer
DO YOU HAVE ANY ADDITIONAL COMMENTS?
Your answer
Although the adoption process may seem time-consuming, it is important to keep in mind that it benefits potential adopters as much as it benefits the animals. This adoption process increases the likelihood that you will adopt the animal that is right for you! Like humans, animals have unique personalities, backgrounds, temperaments and needs. Not every animal is appropriate for every home. Adoption applications and consultations are important tools in the decision making process. This form, along with a consultation with a RFL Representative are designed to help you find the dog most compatible with your lifestyle. RFL is responsible for helping potential adopters assess the compatibility of a companion animal.
I understand and accept that it is RFL’s prerogative to decide which home is most appropriate for the individual dog, and therefore I will not take issue with the decision. Unless otherwise indicated by RFL, I may be considered for another dog.
PLEASE NOTE: You will be asked to sign this application, after the meet and greet, and if you wish to proceed with the adoption.
I HAVE READ THE ABOVE STATED APPLICATION CAREFULLY AND CERTIFY THAT THE INFORMATION I HAVE GIVEN IS ACCURATE AND TRUE. ALSO, IF AN OMISSION OR UNTRUTH IN THIS APPLICATION IS DISCOVERED AFTER AN ADOPTION TAKES PLACE, I UNDERSTAND AND ACCEPT THAT RFL HAS THE RIGHT TO ANNUL THE ADOPTION AND RECLAIM THE DOG. I UNDERSTAND THAT IF THE PET IS RECLAIMED THERE WILL NOT BE A REFUND OF MONEY. THIS AGREEMENT SHALL BE SUBJECT TO AND GOVERNED BY THE LAWS OF THE STATE OF COLORADO.
SIGN YOUR NAME BELOW TO SERVE AS AN ELECTRONIC SIGNATURE AGREEING YOU HAVE READ AND UNDERSTOOD ALL POLICIES AND PROCEDURES. THIS DIGITAL SIGNATURE IS BINDING AND YOU WILL BE REQUESTED TO SIGN A PHYSICAL COPY OF THIS DOCUMENT AS WELL BEFORE THE ADOPTION PROCESS IS COMPLETE.
YOUR SIGNATURE:
Your answer
TODAY'S DATE
MM
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DD
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YYYY
Submit
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