Adoption Form


List the name(s) of dog(s) for which you are applying

Personal Information
Your Name *
Address *
City, State, ZIP *
Why do you want to adopt? *
Evening/Home Phone *
Day/Work Phone *
Email Address *
Occupation
Employer

Household Information
Spouse/Partner's Name
Spouse/Partner's Employer
Spouse/Partner's email
Do you own your own residence? *

If you rent, you must provide Landlord's contact information
Landlord's Name
Landlord's Phone
Landlord's Address

Current Residents
Resident 1 Name
Resident 1 Relation to you
Resident 1 Age
Resident 2 Name
Resident 2 Relation to you
Resident 2 Age
Resident 3 Name
Resident 3 Relation to you
Resident 3 Age
Resident 4 Name
Resident 4 Relation to you
Resident 4 Age
Does anyone in household have known allergies to dogs? *
How many pets currently live in your household? *

List below any cats, dogs, other pets, who currently live in your household
Pet 1, Name
Pet 1, Breed
Pet 1, Age
Pet 1, Sex/Neutered?
Pet 1, How long owned?
Pet 1, Where kept?
Pet 2, Name
Pet 2, Breed
Pet 2, Age?
Pet 2, Sex/Neutered?
Pet 2, How long owned?
Pet 2, Where kept?
Pet 3, Name
Pet 3, Breed
Pet 3, Age?
Pet 3, Sex/Neutered?
Pet 3, How long owned?
Pet 3, Where kept?
For additional pets, please enter their information here.

Dog/Household Information
Why do you want to adopt a rescued dog? *
Have all members of the household been informed of your decision to adopt? *
If no, please explain:
Who will be the dog's primary caregiver? *
Please be clear in your answer. Children cannot be expected to be the primary caregiver. The primary caregiver's responsiblity is to make sure the dog is fed, watered and exercised as well as emotionally and medically cared for.

References
Please provide the contact information for a veterinarian you have used before and plan to use with your new dog. We check all vet references.
Vet Name
Vet Phone
Vet records under the name of:
Please provide the name of at least two personal references. Include their name, phone # and how this person knows you and your ability to provide a good home for a dog:
Reference 1, Name *
Reference 1, Phone number *
Reference 1, How they know your ability *
Reference 2, Name *
Reference 2, Phone number *
Reference 2, How they know your ability
Have you owned a dog before? *
If yes, please provide us a brief history of what happened to the dog. If your previous dog died, please provide the date and circumstances:

When the dog comes home
Do you have a fenced yard *
If yes, type (chain link, electric etc.) & height
If you have no fence, how do you plan to have your dog relieve itself?
How do you plan on giving your dog proper exercise? *
Do all the adults work full time? *
How many hours each day will the dog be home alone? *
Where will the dog be kept when home alone (crated, run of the house, kiddie gated in room(s), left outside, etc? *
Where will the dog sleep? *
What sort of training do you plan on providing your dog?
What type of activities do you plan on doing with your dog? *

Application and Donation
The adoption fee ranges from $250-$450 for most adult dogs (decided on a case-by-case basis). This is to help defray the costs of spaying, neutering, transportation and shots for our dogs. All dogs are spayed or neutered, examined by a vet, given medical  *
You must be 21 or older in order to adopt a dog from All Dog Rescue *
For our records, can you tell us how you heard about All Dog Rescue?

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