Adoption Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out the following information completely and honestly.

Name of the dog are you interested in adopting *

Your name (first and last) *

Please provide the BEST phone number to reach you: *

Email address *

Home Address *

City, State, Zip *

Employer *

Number of adults in the household including yourself? *

Number of children in the household? *

Is everyone in the household in agreement about adopting a new pet? *

Yes

How long have you been at the above address? *

Please check all that apply: *

Own

Rent

Required

If you rent you will need documentation from your landlord that animals are allowed before your application can be approved. Please provide the contact number for your landlord, if applicable.

Landlord Name:

Landlord Phone:

Are animals permitted at your rental?

Yes

Not applicable

Clear selection

If you are a renter, do you have a lease stating animals are permitted?

Yes

Clear selection

Please list animals you CURRENTLY have including breed, sex, age, neutered/spayed, and if they are current on vaccinations. *

We will contact your Vet to confirm your animal's health information. Please notify them that we will be calling to do a vet check. Please provide your CURRENT or PAST Vet Information. If you have never owned a pet before and there is no medical history to confirm, please disregard this section.

Vet Name:

Vet Phone:

Vet Address:

Vet City/State/Zip:

First name the pet(s) and the last name that the vet records are under:

A dog/cat can live up to 20 years. Are you prepared and willing to give the medical treatment it needs for it's life span? *

Yes

Do you agree to have this animal spayed/neutered if it is not already? *

Yes

Are you prepared to bring your pet for its yearly exam and vaccinations? *

Yes

Are you willing and able to attend training classes if needed? *

Yes

Do you understand when adopting an animal that you must be patient and allow time for the animal to adjust to its new house/routine? (This may include house breaking accidents, chewing, barking, whining or hiding) *

Yes

Have you ever relinquished or given up an animal? If yes please explain: *

How did you hear about us? *

Facebook

Petfinder

Adopt-a-Pet

Our Website

Other:

Please Read this Important Information

Our goal is to place the animal in a forever home. If your application is incomplete, dishonest or deemed incompatible in any way, we have the right to decline you without explanation. If incorrect or misleading information is provided your application will be declined for the animal you have applied for and any other animal at this rescue in the future. Our rescue does not adopt to families who currently have animals that are not spayed/neutered. If your animal is not spayed/neutered for medical reasons please make note in the medical information portion of the application. The approval process can take up to FIVE days and all approvals will be contacted via email so please be sure to check the address you have provided. Upon approval and adoption, there is a NON REFUNDABLE $450 adoption fee. All animals are up-to-date on vaccinations, spayed/neutered and micro-chipped. All medical records will be provided to families at the time of adoption.

Due to the high volume of applications, we WILL NOT contact you if the animal becomes unavailable or your application was declined.

By clicking "submit" you certify that the information supplied on this application is true and confirm your acceptance of all terms and conditions stated in this application.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of American Rescue Dog Corporation.

Does this form look suspicious? Report

Forms