Rylie's Rescue Adoption Application
Please complete the form as much as possible. Incomplete information will delay the processing of your application and risk your ability to adopt through Rylie's Rescue. This application is NOT a guarantee of any dog's placement, as a home visit and reference check are REQUIRED before any adoption is completed. Rylie's Rescue reserves the right to determine which applicant will provide the best home environment for the dog.
Sign in to Google to save your progress. Learn more
What is the name of the Dog you are interested in adopting? (We recommend listing multiple dogs in order of preference, in case your first choice is not available.) *
Primary Adopter Full Name *
Primary Adopter's Email Address *
What is Primary Adopter's Physical Address (MUST include street, city and zip code)? *
What is the Primary Adopter's Phone Number? *
What is Primary Adopter's Facebook Name (So we can message you with questions/info)? *
What is the age of the Primary Adopter? (Must be 25+) *
What is the Primary Adopter's Occupation? *
What is the typical work schedule of the Primary Adopter?
What is the number of hours the dog will be left alone? *
Where will the dog be kept during the day? *
Do you own or rent your home? *
If you rent, what is the NAME and PHONE NUMBER of your Landlord?
What type of home do you live in? *
Do you have a fenced in yard? If so, please provide details, including approximate size of yard, fence type and height. *
Are there currently any pets in your home? If yes, please provide ALL of the following: Species, Breed(s), Name(s) and Age(s) of all current pets. *
Are your current pets spayed/neutered? *
Are your current pets up to date on their vaccinations? *
Do you keep your current pet(s) and did you keep any previous pets on heartworm and flea/tick preventatives? *
Please explain any reasons you would have to give up a dog. *
Have you ever surrendered a pet? If so, please explain. *
What is the name of the Secondary Adopter? *
What is the Email Address of the Secondary Adopter? *
What is the age of the Secondary Adopter? *
What is the Secondary Adopter's Phone Number?
 *
What is Secondary Adopter's Facebook Name (So we can message you with questions/info)?
 *
What is the occupation of the Secondary Adopter? *
What is the typical work schedule of the Secondary Adopter? *
How many adults live in the home? *
Do any minors live in the home? If so, what are the ages of the minors? *
Does anyone in the home have allergies to dogs? *
Have you previously had other pets?  If yes, please provide ALL of the following: Species, Breed(s), Name(s) and Age(s) of all previous pets. *
What happened to your previous pets? *
Have you ever taken a pet to obedience classes or used a trainer? *
Please provide TWO (2) NON-Family References AND their phone numbers. *
Please provide the name and number of your current or previous Veterinarians. 

Please contact your vet to give us permission to discuss your pet's vet history. *If you do not contact them to give us permission beforehand, you will not be considered for adoption.
 *
What are your interests with our rescue? Please check all that apply. *
Required
If approved to adopt, when would you like to do so? Please be as specific as possible with a timeline and reason. 
 *
How did you hear about us? (Please be SPECIFIC and provide name of referring friend, if applicable) *
IMPORTANT: Please CAREFULLY review all your answers to questions above to ensure they contain ALL information that is requested. Failure to fully complete answers will result in a delay or removal of your application.  

By placing your date and initials below, you claim that the information you provided is accurate and true and that you have read the disclaimer at the top of the application.
 *
Comments
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms