app test May 21, 2021 APPLICATION TO ADOPT Name of the dog you are applying for? Have you read the entire biography posted for this dog, and understand all information that may be relevant in deciding if this is the right dog for you? Yes Why did you choose to you apply for this particular dog? Do you have an open application with any other organization? If so, what stage are you at? PERSONAL INFORMATION: Applicant's Name (If Applicant is under 25, please provide parental co-applicant) Age: Partner's Name (or Parent's Name if applicant is under 25 yrs) Age: Email Address Phone number Best time to reach you? Street Address City Province Postal Code Total number of people residing in your home (Including applicants listed above) Are there any children living in the home, if so what ages? Are you and your family (if applicable) the sole occupants of the house (e.g.boarders, rental suite, defined apartments, etc)? If not, please provide details HOME INFORMATION: Do you rent or own your home? If rent, provide landlord's name and number. If you rent, are you allowed dogs? YesNoN/A If you rent, are there any breed or size restrictions on animals living in your home? Please provide details. Home size (Sq. Feet) How many years have your been living there? Do you have a yard? Is your yard for your exclusive use? Is your yard fully and securely fenced? Fence description (fully enclosed? partial? chain-link? wood?) If no fence, how will the dog be kept secure? Does anyone at the residence smoke/vape inside your home? Please be aware, we only place dogs in smoke/vape free homes. This is something we check during the home visit stage, so please answer honestly. APPLICANTS EMPLOYMENT INFORMATION: First Applicant's Name Employer Name Years on the job Position Second Applicant Name Employer Name Years on the job Postion GENERAL INFORMATION: Who will be the primary care giver for this dog? How many hours will the dog be left alone, on average, each day? Is someone typically home during the day? Who is the person typically home during the day? How often do you go on holidays? Where would the dog stay while you are on holiday? Do you have any holidays planned in the coming weeks/months that need to be considered while applying for, or introducing a new dog to your home? Have you ever owned a dog before? Do you currently own a dog(s)? Please provide details. If you current own a dog, is this dog spayed or neutered? YesNoN/A Do you have a breed preference? If so, what draws you to that breed? What activity level are you looking for to best match your lifestyle? What activities will you do with this dog? Behaviour wise, briefly describe your ideal dog (cuddly, independent, quirky, obedient, playful, lazy). Do you or anyone in your household have any experience with dogs (e.g. helping friend/family with a dog)? Have you ever owned the mix/breed you are applying for? Aside from dogs, do you have any other pets living in the home? If so, what type of pet(s)? Have all pets (current and past) had their vaccinations kept up to date? (If any) If not, why? Have all pets (current and past) been spay/neutered? (If any) If not, why? Have all pets (current and past) been given heart worm preventative during the suggested months? (If any) If not, why? REFERENCES: (Please note, we DO NOT contact your references without speaking to you first) VETERINARIAN Name of veterinary clinic you use, or used with past pets in the past 10 yrs: Phone PERSONAL REFERENCE 1 First and Last Name Relationship to applicant Phone number Email Address PERSONAL REFERENCE 2 First and Last Name Relationship to applicant Phone number Email Address PERSONAL REFERENCE 3 First and Last Name Relationship to applicant Phone number Email Address Please understand: Understands not guaranteed to be approved for dog selected: yes Understands not first-come-first-serve: yes Understands that there could be behavior issues: yes Understands there may be undiagnosed medical issues: yes Understands there is a fixed donation amount for this pet: yes Understands they may need to travel to pick up this pet: yes I certify that the information provided on this form is true & correct and that nothing of relevance has been omitted. I realize that if any of the information I have provided in this form or during the screening process is inaccurate, misleading, or significant omissions have been made; this may result in my application being denied. I grant my permission for a SAVE ME RESCUE volunteer to contact all stated personal references and veterinarian(s). I am aware that SAVE ME RESCUE does not guarantee the age and breed of this dog and SAVE ME RESCUE bases our information on the opinion of the shelter staff and/or veterinarians. I am financially and physically able to care for this animal. I understand that proper food, water, shelter, and veterinary care, and training is necessary and may be costly, and I am able to meet these requirements. I am willing to seek professional help such as training, if needed. I am aware that Home Visits are mandatory prior to approval for ALL applicants. If, even after an adoption has taken place, it is discovered that information contained in this application or during screening to be false or misleading, SAVE ME RESCUE retains the right to deny your application or remove the animal from your premises without a refund of monies paid. SAVE ME RESCUE reserves the right to deny any application due to the primary interest being the best interest of the animal. Accept all terms and conditions
