Pup Squad Rescue
Dog Adoption Application
Name of Desired Dog:
Name of desired dog
Your name:
Your name
Occupation:
Occupation
Driver’s License Number:
Names/Ages of Children, if any:
Any other occupants in home:
Your home address:
Street:
City, State:
Zip Code:
Daytime phone number:
Evening phone number:
Your email address:
Type of dwelling:
House
Condo
Apt.
Other
Do you rent or own?
If renting, do you have your landlord's permission to have a dog?
Landlord's name and phone number:
What are your primary reasons for wanting a dog: companion for you, for your kids, gift, for other pet, watchdog. Please pick one and if your reason is not listed please explain.
If your children did not want a dog, would you be interested in adopting one for yourself?
Does anyone in your household have allergies? If yes, please describe:
Do you have a pet now?
If yes, list how many pets, Type of pet(s) (if dog, list breed), Age(s), and Sex(es):
Other pets?
Are your pet/s spayed/neutered?
Have you ever allowed an animal to breed?
Is there anybody home during the day?
If yes, who?
When will the dog be inside?
When will the dog be outside?
About how many hours a day will the dog be left alone?
Where will the dog stay when he/she is home alone? (please be as specific as possible; i.e., run of the house, a specific room, a crate, etc.)
Where will the dog sleep at night?
If inside, where exactly? Kitchen , Master Bedroom , Spare room , Laundry room , Run of the house , or Other. If other, or if you have additional comments on where the dog will sleep, please specify:
What rooms are off limits to the dog?
What outside areas are available to the dog? Fenced yard, Enclosed patio, Garage, Balcony Dog house, Unfenced common area, or Other.
Do you have a doggie door?
Type of fencing? (Chain link, wood, block wall, etc.)
Please specify the height of your fence and include the highest point and the lowest point:
I have recently inspected my fence and it is in good condition. Please answer Yes or No.
The fence is intact on all sides and is at least 5 feet from ground level in all areas. Please answer Yes or No.
I promise to inspect my fence thoroughly before the home visit and make necessary repairs for the safety and well being of our new pet. Please answer Yes or No.
Are there gates? Please answer Yes or No.
How many gates and how high?
Is there any type of lock on the gate(s)? Please answer Yes or No.
Type of lock (padlock, key, latch, etc.):
If no locks, would you be willing to install them prior to placement should this application be accepted? Please answer Yes or No.
Who has access to your yard? Gardener Poolman, Utility Neighbor, Other. If other, please explain:
Preferred level of exercise with dog? Couch potato, Short walks, Vigorous walks, Hike or jog regularly:
When you go on vacation, who will care for the dog? (Friend, kennel, dog sitter, etc)
What kind of food will you feed the dog? Please include the brand of kibble, canned, or other:
Do you have a regular vet? Please answer Yes or No.
Name of vet:
Would you like a referral to a vet? Please answer Yes or No.
Who will groom and bathe your dog?
Would your dog wear a collar? Please answer Yes or No.
When?
Would you allow your dog to wear a permanent Pup Squad Rescue I.D. tag? Please answer Yes or No.
How would you rate your level of dog owning experience? First time owner, Beginner, Intermediate, Advanced, or Other. If other, please explain:
How would you discipline your dog if he or she misbehaved?
How would you train this dog? Obedience class, Hit with newspaper, Firm verbal commands, Clicker/hand signals, or Other. If other, please explain:
How do you normally walk your dog? On leash, Off leash. When on leash do you normally use: Collar only, Choke chain, Harness, or Other. If other, please explain:
Are you willing to live with hair on the furniture, stains on your rugs, a warm body on your bed, and an animal that might be destructive at times? Please answer Yes or No.
Pets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, shelter and exercise for your new pet? Please answer Yes or No.
Are you able to make a long-term commitment to care for you pet for its entire life span, which could be as much as 10 to 20 years? Please answer Yes or No.
What would happen to your pets if you moved locally, out of state, or out of the country?
Which of the following reasons might prompt you to give up your dog? (Note all that apply) Excessive barking , Biting, Digging, Moving, Divorce , Poor watchdog, Destructive chewing, Financial Problems, Occasional accidents, indoors Growling at guests, Excessive vet bills, Shedding, Allergies, New spouse/partner doesn't like dog, Aggressive on leash, or None of the above. Also, please include any other comments:
Please list pets you have owned since you have been an adult and the length of ownership; if they are no longer with you, please provide an explanation:
Why are you interested in adopting from a rescue?
Please read and initial each statement below.
I understand that a home visit is required prior to final placement.
I understand that a home visit does not guarantee placement.
I CAN make a donation of at least $300 to help rescue, provide medical care, spay and neuter, board and place other abandoned dogs. (Inability to make a donation does not disqualify an applicant from consideration.) I understand that any donation or contribution is a gift freely given, not a purchase price for a dog.
I agree to provide my own collar, leash, choke chain or harness, and personal ID at the time of completing the adoption contract.
Pup Squad Rescue reserves the right to refuse adoption to any applicant for any reason. This questionnaire becomes part of our contract.
Please list the name of the dog you're interested in again, and tell us why you're interested in this particular dog.
Thank You!