Adoption Application
Pawsitive Endings Adoption Application

By completing and submitting this form you are giving our rescue volunteers permission to contact your landlord, veterinarian and personal references in order to process your adoption application and you are giving those same parties authority to release information on your behalf. Once the application is approved we will proceed with scheduling a home visit. Once the home visit checks out then we will work with you to set up a time to meet the dog you are hoping to adopt. Thank you for applying to adopt a rescue dog and save a life.

Sincerely,
Pawsitiive Endings Dog Rescue

PERSONAL INFORMATION
Full Name: *
Your answer
Spouse/Partner's Full Name: *
If this question is not applicable please list NA as this is a required question.
Your answer
Valid Email Address: *
Your answer
Address (Street): *
Your answer
Address (City, State and Zip Code): *
Your answer
Phone Number (home and/or cell): *
Please list both if you use both numbers. Include Area Code:
Your answer
What hours do you work? *
Your answer
What hours does your spouse/partner work? *
Your answer
How many hours will the dog spend alone each day? *
Your answer
Does anyone in the house have pet allergies? If yes, please explain. *
Your answer
Please list the names and ages of all other persons residing in the household (other than you and your spouse/partner):
Your answer
THE DOG YOU ARE INTERESTED IN
Describe the dog you want (age,sex,size etc.):
Your answer
Name, if known:
Your answer
How much do you plan to spend each month on food, veterinary care etc? *
Your answer
Please tell us a little about yourself, why you want this dog, and why you feel you could provide a good home for this dog. *
Your answer
YOUR HOME & YARD
Do you live in a house, apartment, condo, etc.? *
Your answer
Do you own or rent? *
How long have you lived there? *
Your answer
If less than 2 years, please give previous address:
Your answer
If you rent does your rental agreement permit pets?
Your answer
Landlord's name, address, and phone number (required):
Your answer
Is your property fenced? What type of fence? Height? *
Your answer
If not fenced, how, when, and where will your dog be exercised? *
Your answer
Where will the dog spend its time alone (please be specific)? *
Your answer
Where will the dog sleep at night (please be specific)? *
Your answer
Do you have an emergency plan (in place for your pet(s) in case of flood, fire, etc.)? *
Your answer
CARE AND TRAINING OF THE DOG
Would your dog be living with any of these neighbors/visitors, or encounter any of these situations/activities regularly (check all that apply): *
Required
Which family member will provide the majority of care to this new animal? *
Your answer
Have you ever trained a dog in an obedience class? *
Do you plan to enroll the new dog in class? Why or why not? *
Your answer
If you plan to train dog yourself which training philosophy do you follow (be specific)? *
Your answer
When you go on vacation, where will your dog go and who will care for it? *
Your answer
If you move, what will you do with your dog? *
Your answer
If your dog becomes seriously ill, can you afford to pay vet bills for an extended time? *
Your answer
How long do you feel a dog should be given as an adjustment period? *
Your answer
Is your family willing to work with a new dog on any issues he/she may have? *
Your answer
What behaviors would you be unable to deal with in your dog? *
Required
YOUR OTHER ANIMALS
If you have any pets currently, please list them below:
PET ONE: Name, type, age, sex, on heartworm preventative, on flea preventative, spayed/neutered, lives indoor /outdoor?
Your answer
PET TWO: Name, type, age, sex, on heartworm preventative, on flea preventative, spayed/neutered, lives indoor /outdoor?
Your answer
PET THREE: Name, type, age, sex, on heartworm preventative, on flea preventative, spayed/neutered, lives indoor /outdoor?
Your answer
PET FOUR: Name, type, age, sex, on heartworm preventative, on flea preventative, spayed/neutered, lives indoor /outdoor?
Your answer
PET FIVE: Name, type, age, sex, on heartworm preventative, on flea preventative, spayed/neutered, lives indoor /outdoor?
Your answer
PET SIX: Name, type, age, sex, on heartworm preventative, on flea preventative, spayed/neutered, lives indoor /outdoor?
Your answer
If you do not currently have a dog when did you last have one?
Your answer
What circumstances would cause you to give up a dog?
Your answer
VET REFERENCE
What is the name and phone number to your current veterinarian? *
Your answer
May we call your vet to ask how you take care of your animals? If no, why? *
Your answer
PERSONAL REFERENCES
Please list (2) two non-relatives who have known you for at least 3 years:
1st reference name: *
Your answer
1st reference phone number: *
Your answer
1st reference relationship to you: *
Your answer
1st reference address: *
Your answer
2nd reference name: *
Your answer
2nd reference phone number: *
Your answer
2nd reference relationship to you: *
Your answer
2nd reference address: *
Your answer
I hereby affirm that all of the above information is true and correct. I understand that submission of this application does not guarantee that I will be approved to adopt and that you reserve the right to reject any applicant. I authorize you to verify all information set forth in this application and to contact my personal references.
Signature (Please type your full name below): *
Your answer
Date: *
MM
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YYYY
Thank you for completing the application a volunteer will be in touch with you as soon as we can.
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