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Adoption Application

CHANCES ANGEL RESCUE & EDUCATION & ADOPTION APPLICATION

HOW LONG IS A LIFETIME? ARE YOU REALLY WILIING TO COMMIT?

MOST DOG CAN LIVE TO BE 10-15 YEARS OF AGE OR OLDER.

BEFORE YOU CONSIDER ADOPTING A PET, PLEASE ASK YOURSELF THESE QUESTIONS:

Please consider how old you will be 15 years from now. Will you still be able to care for a pet?
How many times do you think you might move in the next in the next 15 years?
Are you willing to move your pet, too, and restrict your choices of housing to places where pets are allowed?
What major changes might happen in your life for the next 15 years? Marriage? Children? Are you willing to continue spending time, energy, and money to care for your pet when taking on new responsibilities?
What will you do if your spouse or children can’t get along with your pet?
Have you previously owned a pet that didn’t work out? If so, what happened to the pet? What would you do differently with this pet to prevent a similar situation from occurring?

Adoption Application

Step 1 of 2

50%

Name

First

Date

MM slash DD slash YYYY

Home Phone

Work Phone

Alt. Phone

Current Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Drivers License

Drivers License State:

Employers:

Employers Phone

Own Rent Live with parents (Please circle one)

House Apartment Townhouse Duplex Condo Mobile Home Other:

Landlord’s name

Landlord's Phone Number

Are You a student?

Yes

Family Information

Spouse’s Name

First

Spouse’s Employer

Employer Phone

Applicant’s Age?

List the name & ages for all members of your household?

Have you ever surrendered an animal to a shelter? If so, what were the circumstances?

Pet Information

List all your current pets:

Dog

Cat

Other

Lives In or Out

Spayed/Neutered

Name

First

Breed

Age

Section Break

If your pets are not spayed/neutered, please explain:

List all your previous pets:

Dog

Cat

Other

Lives In or Out

Spayed/Neutered

Name

First

Breed

What happened to the pet? How long ago? How old was the pet when deceased?

Name of Veterinarian or Clinic:

Phone # of Vet/Clinic

What pet are you interested in adopting?

What type of exercise will you provide for this pet?

Run on leash

Play fetch/Frisbee

Vigorous play

Swim

Take dog to dog park

Play with other dogs

Agility/Flyball Herding

What are your expectations of activity level for your ideal dog?

Very Active

Mildly Active

Laid Back

Plays Gentle

Is herding instinct/nipping acceptable?

Yes

Why do you wish to adopt this animal?

Gift

Companion

Hunting

Guard/Security

Mouser

Breeding

Other

Where do you plan to keep this animal?

Inside Home

Outside Home

Backyard

Outside Pen

Garage

Chained/Tied

Basement

Crate

Other

Do you have a fenced yard?

Yes

Dimensions:

Do you have a doghouse?

Yes

Type of Fence:

Chain Link

Wood

Electric

Invisible

Welded Wire

Picket

Other

How many hours a day will this animal be left alone?

Where will it be kept when left alone?

If you become unable to care for your dog, will someone else assume that responsibility?

Yes

Have you dealt with us before?

Yes

If Yes: Name of responsible party:

Relationship to you:

Address and Phone number of responsible party?

If so, how, and when?

How did you hear about C.A.R.E.?

With my signature, I certify that I have given accurate, correct information and that information is subject to verification. I also understand that C.A.R.E. has the right to refuse adoption of any animal. I also understand that by submitting this form it becomes property of C.A.R.E. and will not be returned to me. I agree to C.A.R.E. conducting a home and reference check.

Signature

Adoption counselor:

PLEASE EMAIL COMPLETED ADOPTION APPLICATION TO rhonda4care@gmail.com

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rhonda4care@gmail.com
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