Adoption Application
Completion of this application does not guarantee adoption. You must be at least 18 years old to apply and the adopter (do not apply for your parent). Please understand that we are only interested in serious adopters that will make the commitment to adopt a pet and keep the pet for life. Please email this application to or mail to PO Box 51, White Plains, MD 20695. Our current listings of adoptable animals are at We are volunteers so please be patient as we process your application. We ONLY contact applicants if the application passes the initial review. If you don’t get a response, 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 do not share your personal information outside of our organization. Please be upfront and honest with all responses.
Email address *
What type of animal are you interested in? *
What pet(s) are you interested in? *
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):
If a situation arises that you think may affect your pet ownership such as moving, birth of a child, relationship changes/divorce, change of lifestyle, work, or illness, what is your plan for your pets? *
Would surrendering your pets or giving them up ever be an option, and if so, why? *
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: Please specify name, animal type, male/female, if they have been 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 outside of litter box, what steps will you take to find a solution? *
Are any of these issues a deal breaker for keeping the pet? *
Have you ever surrendered, sold, given away, or abandoned an animal? If yes, please explain. *
Have you or anyone in your household ever committed and/or been convicted of a 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. *
Rescue Angels of Southern Maryland reserves the right to refuse adoption to any applicant for any reason. This application becomes part of our contract. Adoption fees are $125 for one cat or $200 for two cats. Some adults/seniors are $75 or $100 for two. Adoption fees for dogs are $300 ($500 for two). Adoption fees for some former breeding stock/purebred dogs and cats may be higher. The adoption fee covers the initial required veterinary care for adoption. A portion of the fee may help provide care for other animals in the organization and is not refundable after 10 days. Rescue Angels of Southern Maryland, Inc. is a registered 501(c)(3) not-for-profit organization. *
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