Adoption Application

Pet ownership is a serious responsibility. We want to make sure that each person who adopts a dog from us is aware of the responsibility and the commitment that owning a dog requires.

This application is designed to help make the best placement possible. Getting the right home for a dog is extremely important to us. Each dog deserves a life-long home.

To make certain that this adoption is in the best interest of both the dogs and their potential families; we ask that you complete the information and questions below. This information will help us place our dogs in the best possible home and at the same time find the best possible dog for you.

To be considered a potential adopter, you must:

• Be 21 years of age or older

• Have the knowledge and consent of your landlord if applicable

• Be able and willing to spend the time and money necessary to provide vaccinations, medical treatment, training and proper care for a pet

• Agree not to chain the animal outdoors

• Not have had an animal who has died of any contagious disease within the last six (6) weeks

• Consent to a home visit with prior notice at a mutually agreed upon day and time

(If you do not meet one of the criteria listed above but feel you are the right home for the dog that you are applying to adopt, please do not let these guidelines stop you from applying. We adopt each dog out on a case-by-case basis and WILL make exceptions for the RIGHT home)
Applicant 1
Name – First, Middle, Last
Date
MM slash DD slash YYYY
Home Address
Work Address
Date of Birth
MM slash DD slash YYYY
Cell Phone
Drivers License
Occupation
Email
Applicant 2
Name – First, Middle, Last
Date
MM slash DD slash YYYY
Home Address
Work Address
Date of Birth
MM slash DD slash YYYY
Cell Phone
Drivers LIcense
Occupation
Email
Do you Own or Rent your home?
If you rent, does your landlord allow dogs?
If you rent, what is your property owner's name?
If you rent, what is your property owner's phonenumber?
If you rent, what is your property owner's email?
How long have you lived at your present address?
Do you plan to move soon?
If so, when/where to?
Names and ages of adults in household
Names and ages of children in household
Are there any medical concerns within the household?
Are you expecting a child or planning to raise a family soon?
If so, how will this affect the dog you are adopting?
Is your new pet going to be an indoor or outdoor pet?
Name(s) of the dog(s) you are interested in adopting
What kind of personality are you looking for in a dog?
Who will be the primary caretaker of the dog(s)?
What type of activities will your dog be involved in?
What other pets have you owned in the past ten (10) years?
Where are those pets now? (please be specific)
Have you ever given up a pet or had one euthanized?
If yes, please state reason
Are your pets current on vaccinations?
Who is your Vet?
What is your Vet's phone number?
May we call your Vet for a reference?
If you have never had a dog in your family, does anyone have experience with dogs? If so, please explain
Do you have a fully fenced yard?
What type of fence?
How high is the fence?
Do you plan to change the name of this dog?
Do you plan on going to formal dog training classes?
How often and by which method do you plan to exercise this dog?
Where will this dog spend most of his time?
How many hours during the day are you away form home?
Where will this dog be when home alone?
What will you feed your dog? Brand and Type
How will you adress long seperations such as extra work hours, vacations, family emergencies, etc?
What will you do with this dog if you move?
This is an extremely important question if you are adopting an American Pit Bull Terrier / American Staffordshire Terrier. Renting is extremely difficult with these breeds and if you are leaving a safe area, be prepared that many other places are NOT safe for the APBT or Am Staff and you might not be able to take the dog with you
Why have you decided to adopt a dog?
Would you be willing to allow us to visit your home as a condition of adoption?

A home visit is required prior to adoption
What will you do if you become financially or physically unable to care for your dog?
Terms and Conditions
To keep this dog in my personal possession, provide proper and sufficient food, water, shelter, grooming and humane treatment at all times
Initials
To not sell, trade, transfer ownership, abandon or dispose of this dog in any way, but to notify this rescue if I must relinquish custody of the dog. This includes but is not limited to family members or friends
Initials
This dog will be maintained as an indoor house pet and family companion. He will not be maintained outside as a yard dog or in a basement, garage or outbuilding. I will not use the dog for medical or any other experimental purpose
Initials
To ensure that when outside and unattended, the dog is in a secure fenced yard. To never allow him or her to run loose without adult supervision. The dog will never be chained or tied outside, in a garage or basement
Initials
This dog will not be transported in the open bed of a pick-up truck or similar vehicle without being enclosed in a properly secured crate
Initials
I, (APPLICANT #1), hereafter referred to as Adopter, hereby agree that the above described dog is being adopted by me solely as a pet for myself and my immediate family. I agree that I will not sell, give away or otherwise dispose of said animal to any person(s), retailer, auction, institute or any other entity for any reason. If at a later date I am unable or unwilling to keep this dog, I agree that I will never take the dog to a shelter or euthanize the dog.
Initials
I agree to care for the above described dog in a humane and responsible manner and to provide it with clean and adequate shelter (must be kept indoors), food, water and veterinary care. I further agree that this dog shall reside inside my home and shall not be allowed to roam freely
Initials
I agree that my dog shall wear a collar or harness with identification tag and be microchipped
Initials
I agree that my dog shall wear a collar or harness with identification tag and be microchipped
Initials
I certify that all statements made by me on this adoption agreement are true and accurate
Initials

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Adoption Application

Adoption Application

Applicant 1

Applicant 2

Terms and Conditions

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CJ’s Dog Rescue