Adoption Application

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Please fill in all areas. If the application is not complete, we can not consider you as an adoptive family for one of our dogs.

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All applicants are subject to a home visit.

We reserve the right to refuse or reject an application for whatever reason we deem fit. By submitting this application for consideration, you are stating that all the given information is true and accurate.

All fees are non-refundable.

Please remember that it can take time to process your application. We will let you know that we have received it, but we will then need time to work on your application to adopt a Rat Terrier.

Thank you!

Are you interested in a particular dog on our site? *

yes

Name of the dog:

Is everyone in the house in agreement about adopting a dog? *

yes

Who will be the primary caregiver and trainer of this dog? *

In what type of training do you plan to participate with your newly adopted Rat Terrier?

Is anyone in the house allergic to animals? *

yes

If so, please explain briefly:

Applicant First and Last Name *

Street Address *

City *

State/Province *

Zip/Postal Code *

Email Address *

Alternate Email Address

Phone (home or cell) *

Alternate Phone (home or cell)

Best time to call (am/pm) *

Employer

Work Phone

May we call you at work?

yes

Clear selection

Spouse/Partner

Please list the names and ages of all persons living in the house. *

Is there someone at home during the day? *

yes

If not, how many hours per week will the dog be without human companionship?

Are there children who frequently visit (grandchildren, stepchildren, etc.)? *

yes

If you have children living at home or have frequent visitors that are children, are you willing to teach them the proper way to handle and treat a dog?

yes

Clear selection

Type of home: *

If other, please explain:

Do you: *

Is your yard completely fenced? *

yes

I do not have a yard

Type of fence:

Height:

If you have an unfenced yard or if there is no yard, how will this dog get exercise and go to the bathroom?

Where will the dog spend the day? *

If other, please explain

Where will the dog stay at night? *

Do you travel frequently? *

yes

If so, what will you do with the dog when you are gone?

Are you financially able to give your new dog the routine medical care he/she requires? *

yes

Have you ever had a dog? *

yes

Have you ever had a rescued animal? *

yes

Name and phone number of rescue:

Do you currently own pets? *

yes

List Name/Type/Breed/Age of pet(s)? (e.g., Sparky, Dog, Rat Terrier, 7 years)

Are your pets spayed/neutered? *

yes

I do not own pets currently

What training have you given your pets?

Are your current dogs receiving monthly Heartworm prevention (Heartgard, Iverhart, etc.)? *

yes

I do not own pets currently

Are your current dogs receiving monthly flea/tick prevention? *

yes

I do not own pets currently

Please list all other pets you’ve had in the last 5 years (names, type/breed/reason the animal is no longer with you): *

Do you have a veterinarian you have used in the past, and plan to use with this dog? *

Name of Clinic/Vet

Clinic/Vet Address:

Clinic/Vet City:

Clinic/Vet State:

Clinic/Vet ZIP/Postal code:

Clinic/Vet Phone:

Clinic/Vet Office hours:

Under which name are the Vet records on your pets?

What circumstances would cause you to return the dog to us? *

If "other," please explain:

Reference 1 *

Please provide the name, address and phone number of someone (not related to you) who can recommend yours as a good adoptive family for a rescued Rat Terrier.

Reference 2 *

Please provide the name, address and phone number of someone (not related to you) who can recommend yours as a good adoptive family for a rescued Rat Terrier.

Reference 3 *

Please provide the name, address and phone number of someone (not related to you) who can recommend yours as a good adoptive family for a rescued Rat Terrier.

Do you agree that this Rat Terrier will be returned to Rat Terrier ResQ if, for any reason, you are unable to keep him/her? *

We hope that we can make a lifetime placement for this dog, but if you cannot keep the dog, we certainly want you to return the dog to us.

Yes

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