Name
*
First Name
Last Name
Date of Birth
*
MM
DD
YYYY
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email
*
Do you:
*
Own your own home.
Rent
Live with parents
If you rent or live with parents, please provide name & contact number.
We will need to verify it is ok for you to have a dog.
Do you have a fenced in yard?
*
Number of adults & children (list ages below) in the home.
*
Does anyone in the home have allergies to animals?
*
Who will be the primary caregiver for the dog?
*
Is everyone in your home supportive of adoption?
*
Where will the dog spend most of the day?
*
Where will the dog sleep at night?
*
List any current pets in the home (species, age, spayed/neutered, vaccinated)
*
Have you owned pets in the past? If yes, what happened to them?
*
Veterinarian Name/Phone Number
*
How many hours a day will the dog be left alone?
*
Where will the dog stay when alone?
*
ex: crate, loose in house, in a room, daycare etc.
How will you exercise your dog?
*
Desired activity level in a dog?
*
Are you willing to adopt a dog that may need:
*
How long are you prepared to commit to this pet?
*
What behaviors would cause you to return the dog?
*
ex: chewing, potty in the house, excessive barking, too much energy, not getting along with other animals etc.
Are you willing to allow a home visit?
*
How did you hear about RescueLove?
*
Reference #1
*
Please provide name & phone number of a personal reference.
Reference #2
*
Please provide name & phone number of a personal reference.
