If a question does not
1: Which dog(s) do you want to adopt?: *
2: Your first and last name: *
3: Your street address: *
4: City: *
5: State and Zip Code: *
6: Phone Number: *
7: E-mail Address: *
8: Date of Birth: *
9: Place of Employment: *
10: Have you ever been charged with animal cruelty or neglect? If yes, please explain the situation: *
11: Why are you adopting this dog(s)?: *
12: For whom are you adopting this dog(s)?: *
13: What are the ages of the children that live in your home?: *
14: Is the dog(s) a gift? If yes please explain who its for?: *
15: If this animal is a gift, does this person know about it and are they asking for this animal?: *
16: How many animals have you had in the past (including childhood)?: *
17: Heres you chance to brag about your current Furbabies: *
18: Please list the Vets office(s) that has current and past records: *
19: Previous or current Vet's phone number(s): *
20: Are your current animals up to date on their vaccines?: *
21: How many animals do you currently have living in your home? (fish tanks count as 1): *
22: Are your current animals up to date on their heartworm preventative?: *
23: What brand of flea control/preventative have you used in the past or are you currently using: *
24: What brand of heartworm preventative have you used in the past or are you currently using?: *
25: How many of your Dogs, Cats or Rabbits are spay/neuterd?: *
26: If your animals are not yet fixed, please explain why, if it will be, and when. If you chose not to, please explain why not?: *
27: Where will this dog(s) live? (indoors, outdoors or both): *
28: Where will your dog sleep?: *
29: Where will this dog be kept in the case of extreme cold or heat temperatures and weather conditions?: *
30: How close do you live to a very busy road?: *
31: Have you ever lost an animal due to being run over? If yes, Please explain: *
32: Do you have a fenced yard?: *
33: Please explain the type of fencing you have, or how you will keep your dog from wondering off: *
34: How much time with in a 24 hour period will this dog spend in a crate?: *
35: How much time will you spend each day with your new dog(s)?: *
36: Do you agree to keep this dog(s) up to date on yearly vaccines?: *
37: Do you agree to keep this dog(s) on monthly flea/tick/heartworm preventative?: *
38: Have you ever adopted from a shelter or rescue before? If so which agency?: *
39: If you adopted for RePets? Please tell us when and who?: *
40: Have you ever surrendered an animal to a shelter or rescue or have you ever got rid of an animal?: *
41: If yes, please explain why you had to give up your animal?: *
42: We understand things dont always work out, and something things happen in life and you must give up your animals. Please list a reason you would need to give up this Dog: *
43: What form of discipline do you use or plan to use?: *
44: What will happen to the dog if you are unable to housebreak this dog: *
45: What will happen to this dog if it chews, gets in to the trash, digs up the yard or is to hyper?: *
46: Would you ever consider putting this dog on a chain or tie out out side? If yes, please explain the possible situation: *
47: Would you ever consider putting this dog in an outside kennel? If yes, please explain the possible situation AND size of the kennel: *
48: If you have to give this pet up for any reason, do you understand that you MUST bring the animal back to RePets Animal Rescue?: *
49a: Current Pets #1 Name: *
49b: Species and/or Breed: *
49c: Vets name AND phone number where this animals medical records are kept: *
49d: Age of this animal: *
49e: Is this animal male or female?: *
49f: How long have you had this animal?: *
49g: If this animal is a Dog, Cat or Ferret is this animal current on its vaccines?: *
49h: If this animal is a Dog, Cat or Rabbit is this animal spay/neutered?: *
49i: If this animal is not yet fixed, please explain why, if it will be, and when. If you chose not to, please explain why not?: *
49j: Where does this animal spend most of the day, and where does this animal sleep?: *
49k: Please tell us about this pets personality: *
49l: Is this animal friendly around dogs? If no please explain: *
49m: How much quality time do you spend with this animal?: *
50a: Current Pets #2 Name: *
50b: Species and/or Breed: *
50c: Vets name AND phone number where this animals medical records are kept: *
50d: Age of this animal: *
50e: Is this animal male or female?: *
50f: How long have you had this animal?: *
50g: If this animal is a Dog, Cat or Ferret is this animal current on its vaccines?: *
50h: If this animal is a Dog, Cat or Rabbit is this animal spay/neutered?: *
50i: If this animal is not yet fixed, please explain why, if it will be, and when. If you chose not to, please explain why not?: *
50j: Where does this animal spend most of the day, and where does this animal sleep?: *
50k: Please tell us about this pets personality: *
50l: Is this animal friendly around dogs? If no please explain: *
50m: How much quality time do you spend with this animal?: *
51a: Current Pets #3 Name: *
51b: Species and/or Breed: *
51c: Vets name AND phone number where this animals medical records are kept: *
51d: Age of this animal: *
51e: Is this animal male or female?: *
51f: How long have you had this animal?: *
51g: If this animal is a Dog, Cat or Ferret is this animal current on its vaccines?: *
51h: If this animal is a Dog, Cat or Rabbit is this animal spay/neutered: *
51i: If this animal is not yet fixed, please explain why, if it will be, and when. If you chose not to, please explain why not: *
51j: Where does this animal spend most of the day, and where does this animal sleep?: *
51k: Please tell us about this pets personality: *
51l: Is this animal friendly around dogs? If no please explain: *
51m: How much quality time do you spend with this animal?: *
52a: Current Pets #4 Name:
52b: Species and/or Breed:
52c: Vets name AND phone number where this animals medical records are kept:
52d: Age of this animal:
52e: Is this animal male or female?:
52f: How long have you had this animal?:
52g: If this animal is a Dog, Cat or Ferret is this animal current on its vaccines?:
52h: If this animal is a Dog, Cat or Rabbit is this animal spay/neutered?:
52i: If this animal is not yet fixed, please explain why, if it will be, and when. If you chose not to, please explain why not?:
52j: Where does this animal spend most of the day, and where does this animal sleep?:
52k: Please tell us about this pets personality:
52l: Is this animal friendly around dogs? If no please explain:
52m: How much quality time do you spend with this animal:
53a: Current Pets #5 Name:
53b: Species and/or Breed:
53c: Vets name AND phone number where this animals medical records are kept:
53d: Age of this animal:
53e: Is this animal male or female?:
53f: How long have you had this animal?:
53g: If this animal is a Dog, Cat or Ferret is this animal current on its vaccines?:
53h: If this animal is a Dog, Cat or Rabbit is this animal spay/neutered?:
53i: If this animal is not yet fixed, please explain why, if it will be, and when. If you chose not to, please explain why not?:
53j: Where does this animal spend most of the day, and where does this animal sleep?:
53k: Please tell us about this pets personality:
53l: Is this animal friendly around dogs? If no please explain:
53m: How much quality time do you spend with this animal?:
54: We understand things don't always work out, something things happen in life and you must give up your animals. Please list a reason you would need to give up this dog(s): *
55a: Past Pets #1 Name: *
55b: Species and/or Breed: *
55c: How long did you have this animal?: *
55d: Vets name AND phone number where this animals medical records where kept: *
55e: Where did this animal live? Indoor, outdoor or both? Please explain both: *
55f: Was this animal spay/neutered? Please explain if you answer no: *
55g: Where is this animal now?: *
55h: If this animals has passed away, what caused the death?: *
56a: Past Pets #2 Name:
56b: Species and/or Breed:
56c: How long did you have this animal::
56d: Vets name AND phone number where this animals medical records where kept:
56e: Where did this animal live? Indoor, outdoor or both? Please explain both:
56f: Was this animal spay/neutered? Please explain if you answer no:
56g: Where is this animal now?:
56h: If this animals has passed away, what caused the death?:
57a: Past Pets #3 Name:
57b: Species and/or Breed:
57c: How long did you have this animal?:
57d: Vets name AND phone number where this animals medical records where kept:
57e: Where did this animal live? Indoor, outdoor or both? Please explain both:
57f: Was this animal spay/neutered? Please explain if you answer no:
57g: Where is this animal now?:
57h: If this animal has passed away, what caused the death?:
PLEASE LIST 3 PEOPLE
58a: Personal Referance #1 Name: *
58b: Phone Number: *
58c: How do you know this person?: *
59a: Personal Referance #2 Name: *
59b: Phone Number: *
59c: How do you know this person?: *
60a: Personal Referance #3 Name: *
60b: Phone Number: *
60c: How do you know this person?: *
61: Do you own, rent, live with parents, or other situation? Please explain if needed: *
62: If you rent, What is the land lords name and number?: *
63: If you live with your parents or another person that is responsible for the property that you are living in, please give th name and number: *
64: Will there be other animals that do not belong to you living where the dog you want to adopt will be living?: *
65: If you answered yes to #64 please list the animals owners name, species, name, age, if its spay/neutered and which office this animal is vetted at: *
66: When we rescue animals we make a promise to them to do the best we can to place them in a forever loving home that best fits THEIR needs. Why do you think this dog is a perfect fit for your family and home?: *
67: Do you understand that if it doesnt work out, you MUST bring this animal BACK to RePets Animal Rescue?: *
68: Do you understand that RePets Animal Rescue is not responsible for medical center after the pet you have adopted goes home?: *
69: Do you understand there is NO REFUND of any adoption fees if the animal does not work out?: *
70: Do you understand that if ANY information given on this application is found to be false, or if we find the animal you are adopting from RePets is not being given proper care (personal or veterinarian) we WILL reclaim the animal(s)?: *
71: Part of the adoption process is that you the adopter will sign a contract promising that you will care for the animal(s) in a responsible and humane way, and if you are ever unable to care for this animal(s) you agree to bring them back to RePets Animal Rescue. By initialing I understand that if granted permission to adopt this animal (s) that I am under contract to bring the animal(s) back to RePets Animal Rescue if I am not able to properly care for this animal(s)in a responsible and humane way: *
72: Part of the adoption process is that you the adopter will sign a contract promising that you will care for the animal(s) in a responsible and humane way, and if you are ever unable to care for this animal(s) you agree to bring them back to RePets Animal Rescue. By initialing I understand that if granted permission to adopt this animal (s) that I am under contract to bring the animal(s) back to RePets Animal Rescue if I am not able to properly care for this animal(s)in a responsible and humane way: *
Thank you for applying to adopt a furbaby from us. We will process your application as soon as possible, please check your email in case we have questions or updates to this adoption process.
DOG ADOPTION APPLICATION
