Dog application

APPLICATION TO ADOPT
(Applicants must be over 18 years of age)
Completion of the application does not guarantee adoption.

Name:

Address:

City:

State:

Zip Code:

Date:

Home Phone:

Work Phone:

E-mail Address:

Please give the name of the animal you wish to adopt:

Why do you wish to adopt this animal? Please answer in detail.

Have you ever owned a pet before: YesNo

Do you currently have animals: YesNo

Number of cats:

Are your cats accustomed to having dogs near them? YesNo

Number of dogs:

If you have a dog, what breed of dog do you own and how old and are they male or female?

Are your dogs socialized, and friendly with other animals? YesNo

Are your pets Spayed/Neutered? YesNo

If no, please explain why not:

Are your pets up to date on all vaccinations? YesNo

If no, please explain why not:

Have you at any time had any pet related diseases in your household? (i.e. Parvo, Distemper, Kennel Cough) If so, please explain:

Have you ever had an animal euthanized? YesNo

If so, please explain why:

Have you ever given an animal away? YesNo

If so, please explain why:

What type of animal are you wanting to adopt? (One that is: calm, active, a protector, a lap dog, etc)

What age of animal do you prefer:

Will the animal be for Search & Rescue, Agility, Hunting, Herding, or as a Guard Dog? If so, please specify which:

Do you plan to take this animal through the basic Obedience Course? YesNo

Do you understand that changing environments with a new pet may cause the animal to have accidents for a time, in the early days of adoption? (i.e. such as marking their territory) YesNo

Since this would be an accident (if this arises) what steps will you take to work on the problem?

If the pet is not fully house trained, as a puppy, will you take the time to work with the pet on house training? YesNo

Will this pet be a family pet or a senior citizens companion?

If a senior companion, please explain the reasons for adopting for the senior:

What will you do with the pet, if you travel?

In the absence of the owner, at any time, and for an extended period of time who will care for the animal?

Will someone be home with the animal during the day? YesNo

How many hours will the animal be left unattended?

Where will the animal be kept when you are not at home? (Please provide details)

Where will the animal sleep? (Please provide details, i.e. inside, outside, kennel, etc.)

How many people in the house hold?

Do you have children? YesNo

Number of children:

Ages of children:

If your child is five years or under, are they accustom to being around puppies or older dogs? (Please expain in detail)

Often times we find puppies tend to take the backseat when young children are in the picture. Puppies just do not know their boundaries and we find it is not fair to put them in that environment.

Do you rent or own?

If you rent, is the pet allowed in the rental? YesNo

What type of housing do you live in (i.e. House, condo, apartment, mobile home, etc.)

If renting, please give the Landlord's name and phone number:

Do you have a fenced yard? YesNo

If your yard is fenced, what type of fence do you have and how high is it?

Where will the new pet be kept most of the time? Where does your currant animals spend most of their time? (i.e. home, yard, kennel, etc.)

What type of excercise and activites will be available for this pet? Is a doggie door available?

Do you realize that it will take time for the animal to bond, it will not take place in just a few hours, a few days, or even possibly a few weeks. Will you be willing to take the time to work with the animal, and make sure it is not traumatized by being returned in a short period of time? YesNo

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Please list two personal references including your veterinarian:

Veterinarian's Name:

Veterinarian's Number:

Personal Reference's Name:

Personal Reference's Number:

I authorize the Yakima Valley Pet Rescue and Adoption Center to check my references? YesNo

Be it understood if an animal is returned for any reason to Yakima Valley Pet Rescue, according to our agreement,(which you receive when adopting) the decision for a refund will be decided upon by the board of directors.

Yakima Valley Pet Rescue and Adoption Center reserves the right to refuse to adopt any pets to applicants we feel would not be in the best interest of the animal. We also reserve the right to refuse any adoption ,without justification, and not all applications or inquiries may receive a response.

I understand that Yakima Valley Pet Rescue is not responsible for the accuracy of information received about  temperament or habits of puppies / dogs available for adoption.  I understand completely that it is my responsibility to evaluate  the dog for myself before agreeing to adopt it.  Yakima Valley Pet Rescue is in no way liable or responsible for any damage, accident, or injury resulting from the placement  of a dog into a household.

Adoptee's also need to pick up the dog (if your application has been approved) in a timely manner, as we need to free up our foster home space to take in more homeless pets is crucial.

Agreed upon:

Application completed and signed by:
Date:
(Typed signature is accepted by Yakima Valley Pet Rescue)

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YVPRAC ONLY

Application reviewed by:   

2nd letter follow up;

Adoption completed;

Other notes;