Adoption Application

We are committed to matching the right dog to the right family so all will have many happy years together. Our adoption process includes the completion of an application, phone interview with our Adoption Coordinator, personal references, veterinary reference, phone interview with your dog’s Foster Mom, home visit, adoption fee and contract.

I want to adopt the dog named *

I understand adoption fee is $175 *
I'm ready to adopt now *
I understand dog is in Southern foster home *

First Name *
Last Name *
Street *
Street2
City,ST Zip *
Email Address *
Home Phone Number *
Mobile Phone Number *
* = entry is required

Identify all Household Members(include self)

Household Members	Age	Occupation

Current Pets

Name	Type	Age	Breed	Gender	Altered

Have you ever owned a dog?
If Yes what breed and what happed to the dog?

Will your rescue dog be around children under the age of 10?

Do you rent or own your home?

How long at current address?

If rent do you have landlord's permission to have a dog?

If rent please provide landlord :

and phone #

Where will dog be kept during the day?

Where will dog be kept during the night?

How many hours will the dog be left alone during the day?

Do you have an adequately fenced yard?

Will the dog be allowed in the house?

Will the dog have free run of the house?

Will you crate the dog?

Will you keep the dog on a runner or tied outside?

Will you walk your dog daily?

Will your dog receive obedience training?

References

Vet's Name:

Vet's Address:

Vet's Phone:

Personal References (list 2 not a relative or household member)

Name:

Phone:

Relationship:

Name:

Phone:

Relationship:

May we visit your home prior to adoption approval?

Are you aware that the annual cost to own a dog can exceed $500?

Do you understand your local ordinances for licensing and leashing?

Have you sold, given away, or surrendered a pet to a shelter, pound or humane society?

Have you or any member or your family been cited for animal cruelty?
If yes, please explain:

Tell us why you wish to adopt this particular dog:

Comments

Applicants Name: *

Today's Date: (mm/dd/yyyy) *

* = entry is required

True and accurate

By submitting this adoption application, you attest that the information is true and accurate to the best of your knowledge.

Privacy policy

Your privacy is critically important to us and we are committed to protecting your privacy. Good Dog Rescue will not make your personal information available to any other organizations or companies.

We reserve the right...

to refuse any applicant for any reason if we feel the needs of the dog will not be properly met or the adoption is not in the best interest of the dog.