Dog Adoption Application

* = required

ADOPTER INFORMATION (Applicant)

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Email Address *

Telephone Number *

Date of Birth *

* You must be 18 years of age or older *

Driver's License/ID# *

* This will be verified during the home visit *

Employment Status *
—Please choose an option—Employed Full TimeEmployed Part TimeUnemployedRetiredOther

If employed, what is your occupation?

What type of dwelling do you live in? *
—Please choose an option—HouseDuplexApartmentMobile HomeCondo/TownhouseOther

Do you own or rent? *
—Please choose an option—RentOwn

If you rent, does your landlord and lease allow pets? *
—Please choose an option—YesNoUnsureI don't rent

If you rent, please provide your landlord's name & phone number, so we may contact to verify they are ok with you adopting OR provide a complete copy of your lease agreement, including the pet clause.

Do you live in an HOA? *
—Please choose an option—NoYes

If you live in an HOA, can you have a dog in your home? Are there any restrictions regarding size, breed or number of pets? Prior to adopting, please be prepared to show a copy of your HOA policy or written confirmation that you are allowed to have a dog.

How long have you lived at your current residence? *
—Please choose an option—0 - 6 Months7 - 12 Months1 - 3 Years4 - 5 Years6 Years or More

Are you on Facebook? *
—Please choose an option—YesNo

Have you ever been accused or charged with abuse or neglect of a child or animal? *
—Please choose an option—NoYes

Have you ever been accused or charged with domestic violence? *
—Please choose an option—NoYes

Emergency contact name and phone number *

Please provide a personal or professional reference * (name and phone number)

What type of reference is this individual? *
—Please choose an option—PersonalProfessional

Do you want to Join our E-Newsletter?
—Please choose an option—YesNo

HOUSEHOLD INFORMATION

Are you the head of the household? *
—Please choose an option—YesNo

What is the level of activity rate in your home? *
—Please choose an option—Very Quiet12345Very Active

Please list the names of all adults living in the household with you and their relationship to you. If there are no other adults, please type in the word "N/A". *

Please list the names of all children living in the household with you along with their age and their relationship to you. If there are no children living with you, please type in the word "N/A". *

Are ALL members of the household in complete agreement with adopting? *
—Please choose an option—YesNo

Are you or any members of your household allergic to dogs? *
—Please choose an option—NoYes

Please describe your yard enclosure, including fence/wall material, height at lowest point, height and material of all gates, type of latch/lock, and if you have a pool or not. *

Are there pets currently in the household? *
—Please choose an option—YesNo

Has your home ever been exposed to Parvovirus? *
—Please choose an option—NoYes

If you have pets in the household, how many do you have? *
—Please choose an option—12345+I don't have any pets in the home

If you have pets in the household, will they adjust to a new pet in the home? *
—Please choose an option—YesNoUnsureI don't have any pets in the home

If you have pets in the household, how do you think they will react to a new dog? * —Please choose an option—FineUnsureNot goodTerritorialI don't have any pets in the home

If you have pets in the household, how do you plan to introduce them to a new dog? If there are no pets currently in the household, please type in the word "N/A". *

Describe your ideal dog. *

DOG INTERESTED IN

What is the name of the dog(s) at Fetch Animal Rescue you are interested in adopting?

Tell us about yourself, describe your typical Home/Work schedule and why you like this dog. *

CURRENT PETS IN THE HOUSEHOLD

**** If you have pets in the household. please state their name, age, and type/breed. Also, select the applicable characteristics for each pet. ****

Pet # 1

Pet # 1 Characteristics (select all that apply)
MaleFemaleSpayedNeuteredCurrent on VaccinationsBehavior IssuesHealth IssuesFriendlyShyTimidHigh EnergyLikes DogsLikes CatsDoesn't Like DogsDoesn't Like Cats

Pet # 2

Pet # 2 Characteristics (select all that apply)
MaleFemaleSpayedNeuteredCurrent on VaccinationsBehavior IssuesHealth IssuesFriendlyShyTimidHigh EnergyLikes DogsLikes CatsDoesn't Like DogsDoesn't Like Cats

Pet # 3

Pet # 3 Characteristics (select all that apply)
MaleFemaleSpayedNeuteredCurrent on VaccinationsBehavior IssuesHealth IssuesFriendlyShyTimidHigh EnergyLikes DogsLikes CatsDoesn't Like DogsDoesn't Like Cats

Pet # 4

Pet # 4 Characteristics (select all that apply)
MaleFemaleSpayedNeuteredCurrent on VaccinationsBehavior IssuesHealth IssuesFriendlyShyTimidHigh EnergyLikes DogsLikes CatsDoesn't Like DogsDoesn't Like Cats

ADOPTION QUESTIONS

Please tell us why you want to adopt a dog? *

Regarding leadership skills with dogs, on a scale of 1 to 10, what is your pack leadership level? * (10 being strongest leader and 1 being all love)
—Please choose an option—12345678910

How will you confine the dog to your property? * (select all that apply)
In the house, cratedIn the house, free rangeIn the house, in a designated roomFenced yardChainedIn the garage, cratedIn the garage, free rangeIn the garage, in a designated areaOther

If you don't have a fenced yard, how will you let the animal out to go to the bathroom? * (If you do have a fenced yard just type in "N/A")

Will there be times when the dog is tied up? *
—Please choose an option—NoYesUnsure

Will the dog be predominantly living inside, outside, or both? *
—Please choose an option—InsideOutsideBoth

How many hours a day average will the dog be left alone? *
—Please choose an option—Up to 1 hourUp to 2 hoursUp to 4 hoursUp to 6 hoursUp to 8 hoursUp to 10 hoursUp to 12 hoursMore than 12 hoursUnsureThe dog will never be left alone

Where will you leave the dog when he/she is home alone? *

If the dog will be crated, whether home alone or not, how long will it be crated for? * —Please choose an option—Up to 1 hourUp to 2 hoursUp to 4 hoursUp to 6 hoursUp to 8 hoursUp to 10 hoursUp to 12 hoursMore than 12 hoursUnsureThe dog will never be crated

Where will your dog sleep/rest after sundown? *
—Please choose an option—Outside under the starsCurled up in bed with meA crate inside the houseOn a dog bed in the houseWherever the dog wants in the houseCrate in Garage

How will your dog be cared for when you go out of town? *

Will you consult a trainer if behavior issues develop? * —Please choose an option—NoYesUnsure

How are you planning on training your dog? *
—Please choose an option—Group puppy classesPrivate trainerI'll teach him/her myselfI don't plan on training my new dog

We cannot guarantee dog to be house trained, are you equipped to train with love and patience? * —Please choose an option—NoYes

What would cause you to return your dog to the rescue? *

Apart from quality or end of life decisions, would you euthanize your dog due to high vet bills? * —Please choose an option—NoYes

Would you allow a home visit by a Fetch Animal Rescue representative if requested? * —Please choose an option—NoYes

What provisions would you make should your dog unfortunately survive you? *

What is the name and phone number of your current or previous veterinarian/veterinary hospital?

Please add any additional information you want us to consider when we evaluate your application. If there is nothing additional, please type in the word "N/A". *

*** This application will be retained by Fetch Animal Rescue. If approved, this application will become part of our adoption agreement. We will not share your information with anyone and will only use it to make an informed decision concerning a Fetch Animal Rescue dog in need of adoption ***

I understand that in order to complete the processing of my application, a visit to my home will be scheduled by a representative of Fetch Animal Rescue prior to adoption. By submitting this application, I agree to such a scheduled visit.

I understand that the adoption fee is NON REFUNDABLE. The adoption fee helps cover the medical costs for all of our dogs, not just the one you would like to adopt.

I understand that any misrepresentation of the above information authorizes Fetch Animal Rescue to deny my application.

I acknowledge that Fetch Animal Rescue cannot guarantee any animals against parasites, diseases, unknown illnesses/conditions or destructive behavior. If I adopt a dog from Fetch Animal Rescue, I will not hold Fetch Animal Rescue responsible, nor seek any compensation for damages, medical fees or other liabilities incurred by the pet I adopt.

I understand and agree that if I rent, my landlord may be asked for a signed acknowledgement or personal meeting, prior to finalizing the adoption.

I certify that all the information provided by me in this application is true and correct.

I give FETCH Animal Rescue permission to verify any and all statements made in this application.

I understand that this application does not guarantee approval of adoption by FETCH Animal Rescue.

I acknowledge and understand that there are multiple steps in the adoption process in order to be approved by Fetch Animal Rescue to adopt a dog from them. The 4 steps are as follows:

Step 1: Submit an application to adopt.
Step 2: Have a phone meeting to go over your application and any additional questions I or a Fetch representative may have. If both Fetch and I agree to proceed we will move onto the next step.
Step 3: Schedule and have a home check visit. If successful and satisfactory to Fetch, I will move onto the final step of the process.
Step 4: The final step is to sign a DOG ADOPTION CONTRACT/AGREEMENT. Once this is signed off on by me and the Fetch Adoption Representative, I will be considered the legal adopter/owner of the said animal listed in this adoption contract/agreement as of the date listed in the contract/agreement.

I accept and agree that I can be denied from being allowed to adopt a dog from Fetch Animal Rescue for any reason(s) they see fit. Due to this, I accept their decision fully with no reservations or concerns. Therefore, I hereby agree to indemnify and save and hold harmless Fetch Animal Rescue, its employees, founders, representatives, volunteers, agents, members, directors, officers, or any affiliated entities thereof, for their reasons and decision.

I accept and understand that I will be required to sign a Dog Adoption Contract/Agreement in order to adopt a dog from Fetch Animal Rescue.

I understand and agree that I am fully responsible and liable for the dog once adopted.

I hereby agree to indemnify and save and hold harmless Fetch Animal Rescue, its employees, founders, representatives, volunteers, agents, members, directors, officers, or any affiliated entities thereof, from ANY LOSS, LIABILITY, DAMAGE, OR COST INCLUDING BODILY INJURY OR POPERTY DAMAGE ARISING OUT OF OR RELATED TO THE ADOPTION OF AN ANIMAL FROM FETCH ANIMAL RESCUE.

I accept that by completing and submitting this application form, I fully understand and agree to assume all risks involved in adopting a dog from FETCH Animal Rescue. I agree to hold FETCH Animal Rescue harmless for any injury(s), loss or damages which I might sustain from adopting a dog. This waiver does include myself, all of my family members and descendants forever from seeking any legal action whatsoever against FETCH Animal Rescue or its successor organizations or any representatives thereof.

I accept and understand that by clicking the submit button, this will serve as my signature with the submission date as the signature date, and that this application will be printed out by Fetch with my answers, and a formal signature will be required and obtained from me during the home check visit, which is Step 3.