Adoption Application
PLEASE READ FIRST: Completion of this application does not guarantee adoption.  Please understand that we only move forward with and respond to applications that show clear commitment to adopt a pet to be included as family and keep the pet for life. If you don’t get a response within 2 weeks of applying, your application was not approved.  We do not operate first-come first-serve and reserve the right to refuse any application at any time. We adopt to homes within 100 miles of Waldorf, MD (with some flexibility). Our current listings of adoptable animals are at and also on Petfinder.  We are volunteers so please be patient as we process your application. Thank you for your interest. 
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Email *
What type of animal are you interested in? *
What pet(s) are you interested in (listed name)? *
Are they male or female? *
If this pet is not available, will you consider another? *
How did you find out about this cat/dog? *
Would you be interested in fostering this cat/dog with intention to adopt? *
Have you applied to adopt with us before? If so, when? *
Have you recently applied to adopt with another rescue/shelter? If so, which organization(s), when, and was your application approved or denied? *
What is your first name? *
What is your last name? *
What is your occupation? *
How many people are in the household (if children, provide ages)? *
Address: *
City: *
State: *
Zip: *
Phone: *
Do you live in a *
How long have you lived at this address? *
How long do you plan to live at this address? *
Do you *
If you do rent do you have your landlord's permission to have a pet?
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Landlord's Name, Phone Number/Email (Please email a copy of the pet policy):
We want committed adopters that consider their pets in all life decisions.  Would surrendering/giving up/rehoming your pets ever be an option? If so, why? *
Have you ever surrendered, sold, given away, or abandoned an animal? If yes, please explain. *
Are you or anyone in the household a smoker? *
Do you understand that we have an indoor only policy (pet must live indoors)? *
How long will the pet be left alone daily and why? *
When you are on vacation or travel, who will take care of the pets? *
What area(s) of the house will the cat/dog be allowed in? *
For Dog adoptions: Do you have a fenced yard? (what type and how high)
For Dog adoptions: Do you have experience with crate and obedience training?
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For Dog adoptions: Will you be able to walk/exercise/play with your dog daily?
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For dogs that we recommend must continue with behavior modification training after adoption, we will require that you have a program set up with a trainer. Some dogs we require to be adopted by local families due to continued training with our trainers. Please initial stating you understand the above statement.
Who will be primarily responsible for taking care of the pet (feeding, exercise, vet care)? *
Does anyone in your household have allergies (if yes, what kind)? *
Do you have a veterinarian? If so, vet's name? *
Name of Clinic:
Clinic Phone Number:
Clinic Address:
If you currently do not have a vet, would you like us to recommend one to you?
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List all pets you have owned within the last 10 years: Include name, animal type, male/female, spayed or neutered, age, how long you have had them, indoor or outdoor, and where the pet is now. *
Did all of the pets listed above receive annual and emergency vet care as needed?
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Why are you interested in adopting? *
Are you able to make a long term commitment to your pet as a family member for its entire life span, which could be as much as 20 years? *
Are you able to financially support your new pet and have you included into your budget the cost of food, supplies, annual and emergency vet care? If a serious medical condition arises, what will you do? *
If behavioral problems arise, such as aggression, biting, clawing furniture, chewing, or urinating inside the home, how will you handle? *
Are any of these issues a deal breaker for keeping the pet? *
Have you or anyone in your household ever committed and/or been convicted of a serious crime, animal/child abuse, or neglect? *
Please provide the name, relationship, phone number, and email for two references (coworker, neighbor, vet, pet sitter, etc.): *
All animals must live indoors with the family only. Cats cannot be declawed. Dogs must not be crated for long periods of time or left outdoors. *
Email address *
With my signature, I am attesting to the truthfulness of my responses and my intent to adopt an animal from RASM. Falsification of any of the above information will be grounds for rejection of this application and possible removal of adopted cat or dog from my home. I consent to RASM representatives discussing information on this application with any persons named on the application. RASM reserves the right to refuse an application for any reason. All completed applications become property of RASM.  I give RASM permission to fully investigate the information provided as well as contact veterinarians and related officials. If the application passes this review, I agree to a home visit on a mutually agreed date by a RASM representative before an adoption decision is made.  I agree to follow up home visits and welfare checks of the adopted pet.  I understand that completing this application is not a guarantee that I will be approved for adoption. (initial below) *
Adoption fees are $150 for one cat or $280 for two cats.  Discounts may apply for senior cats, barn cats, etc. Adoption fees for dogs are $350-$600.  The adoption fee covers the required veterinary care for adoption and varies due to spay/neuter fees per body weight. The fee is not refundable after 10 days of adoption. An adoption folder with health record and adoption contract is provided at adoption.  Rescue Angels of Southern Maryland, Inc. is a registered 501(c)(3) not-for-profit organization.   *
A copy of your responses will be emailed to the address you provided.
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