Adoption Application

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Long Dogs and Friends Rescue - Please note, all questions require answers. If it does not apply to you, please choose or type NA (Not Applicable). Thank you for understanding.

Email *

Full Name *

Street Address *

City *

State *

Zip Code *

Cell phone or home *

E-mail *

* You must enter an e-mail address to submit this application.

Name of Dog *

If you are applying to adopt a specific dog, please enter the name of the dog here.

How did you hear about LDR? *

Are you working with another rescue or shelter at this time? *

Preferences

Preferred Color: *

Preferred Coat: *

Preferred Size: *

Gender: *

Preferred Age Range: *

If you indicated preferences, please explain. Are you flexible? Do you have a second choice? *

Are you willing to adopt a mix? *

Are you willing to adopt a dog that has been abused and therefore may be anxious or may take a while to warm up to you? *

Are you willing to adopt a dog that is not reliable with children? *

Are you willing to adopt a dog that has a physical deformity or handicap? *

Are you willing to adopt a dog that requires ongoing medication other than heartworm preventive? *

Are you willing to adopt a dog that is not completely housebroken? *

Are you willing to adopt a pair of dogs that cannot be separated? *

Your Pets

Do you or anyone in your home currently own, foster or watch any animals? *

If yes, please provide name, species, breed, weight and age of each: *

If you own dogs, how would you describe their personalities? Dominant, submissive, playful, aloof, etc.: *

If you own cats, have they been exposed to dogs? How do they react? *

Have ALL of the animals listed above (if any) been spayed or neutered? *

If no, what are the circumstances? *

If you have previously owned dogs, what happened to those no longer living with you?: *

Please provide a complete answer (e.g. if a dog died, what was the cause of death and age of the dog?)

You And Your Family

Please list your age and the name, age and relationship of all people residing with you: *

How often, on average, do other people visit your home? *

Explain briefly how you will introduce visitors to your dog. *

How have you taught your children (or how would you teach visiting children) to interact with a dog? *

Who will be the primary caregiver for the dog? *

Who will care for the dog when the primary caregiver is away--at work or on vacation?

How many hours will the dog be left at home alone during the day? Where will the dog be kept during those hours? *

Type of residence: *

Own or Rent: *

Is your yard completely fenced? *

If so, how high is the fence? *

If renting, is landlord agreeable to you having a rescued dog? *

If renting, please provide the name, address and phone number of your landlord: *

Please provide Name, Street Address, City, State, Zip Code & Telephone Number

Is your a home smoking or non-smoking home? *

Living with a Dog

What would you say are the best small dog characteristics? The worst? *

What routine medical treatments/preventives do you consider necessary for a dog? [Please include specifics.] *

About how much would you expect to spend annually on medical care for a healthy dog? *

Are you familiar with IVDD? If so, are you familiar with the treatment options? [Please include specifics.] *

Please describe what you know or assume about the special needs of rescue dogs: *

What is your opinion of obedience training? Have you ever done it with one of your dogs? *

Where will the dog sleep? (Please be specific: what floor/room in house? in crate, big bed, dog bed?) *

What do you intend to feed your dog? Please be specific, including brand. *

References - Veterinarian

Please provide the name, location and telephone number of your veterinarian (required for all applicants who have owned a companion animal).

NOTE: By submitting this application, you give permission to Long Dogs And Friends Rescue to retrieve information from your veterinarian. PLEASE CALL YOUR VET AND TELL THEM TO RELEASE THE INFORMATION WE NEED TO LONG DOGS WHEN THE REPRESENTATIVE CALLS! We cannot process applications without information from your vet.

Veterinarian's name: *

Veterinarian's Full Address (Stree Address/City/StateZip): *

Veterinarian's Telephone: *

NON FAMILY References - Personal

Please provide the name and telephone number of at least two people who know you well and are not family members. An employer, co-worker, clergy, neighbor or associate in an organization are good examples. Please let your references know someone from Long Dogs will be calling them about you.

Non-Family Personal Reference Name #1: *

Non-Family Reference #1 Telephone: *

Non-Family Personal Reference Name #2: *

Non-Family Reference #2 Telephone: *

If approved to adopt, when would you like to do so? Please be as specific as possible. *

Comments? *

Signature

The information provided in this application (in its entirety) is true to the best of my knowledge as of the date on this application.
I agree that submission of this form will constitute a legally signed document.

Enter your name here to "sign":

Signature (Your Name Here): *

Date: *

YYYY

A copy of your responses will be emailed to the address you provided.

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