Adoption Application
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Start to copy here: Name of dog you would like to adopt: How did you find TTR? Personal Information Name: Address, apt #: City, State, Zip: Age: Phone #: (indicate if home/work/cell, and include area code) Best time to reach you: E-mail address: Occupation: Current employer: How long have you worked at your present job? How long do you work each day? Does your job require you to travel? Home Environment Do you live in a house, townhouse, condo, coo-op, or apartment? How long have you lived at this address? Do you own or rent your current residence? If you rent, have you confirmed with your landlord that you can have pets? When does your lease expire? Do you plan to move within the next year? If you own a townhouse, condo or co-op, have you confirmed with the managing agent that you can have pets? Are you willing to provide a copy of your lease or a notarized statement from your landlord or managing agent authorizing pet occupancy? Do you have a yard? If yes, is it fenced? If yes, have you inspected the fencing carefully to ensure that there are no holes where a small dog could escape or dig through? Do you have a doggy door? Do you have a deck or terrace? If yes, can a small dog fit through the railing and fall off? Household Information Names, ages, and relationship of everyone in your household: Do you or any member of your household have any medical condition (including allergies or asthma) that might interfere with adopting a dog? Does everyone in the household want to adopt this dog and agree to participate in his/her care? If no, then why? Present / Prior Pets Please list all pets currently in your home (name, male/female, age, breed/species): Are they all spayed/neutered? If no, then why? Are they all current on their vaccinations and heartworm prevention? Where did you get your pets (breeder, shelter, stray): If you have pets in your home at this time, why do you want to adopt another? What prior pets have you owned: What happened to these pets? Have you ever had to have a pet euthanized? If yes, why? Have you ever had a pet lost, poisoned, hit by a car, seriously ill or suffer from a chronic condition? Please explain: Have you ever brought a pet to a shelter? If yes, then why? Have you ever participated in obedience or agility classes? Responsible Dog Ownership What will you like most about having this dog? What will you like least about having this dog? Will you clean up after your dog in public places? Will you abide by leash laws? Will you allow the dog to run loose? Rescued Dog Why do you want to adopt a dog? How long have you been looking for a dog? Have you applied for any other dogs? What are you looking for in a dog? (i.e. breed, age, size, personality, energy level) How long will the dog be left alone each day? Where will the dog stay when you are not home? Where will the dog sleep? Where will the dog eat? Where will the dog relieve him/herself? How will the dog be exercised? How will you groom the dog? (coat care, nail clipping, ear cleaning, teeth cleaning) Who will care for the dog if you travel? Are you willing to participate in obedience classes or seek professional advice if the dog exhibits behavioral problems? If no, then why? Please provide any additional information that you would like TTR to consider when reviewing your application. References Please provide three personal references, over the age of 18, who are not living with you. Two of these references must not be related. Name: Age: Relationship: Address: City, State: Phone # (indicate if home/work/cell, and include area code) Best time to call: Name: Age: Relationship: Address: City, State: Phone # (indicate if home/work/cell, and include area code) Best time to call: Name: Age: Relationship: Address: City, State: Phone # (indicate if home/work/cell, and include area code) Best time to call: Please provide a veterinary reference if possible. Check which applies: ( ) This is my current veterinarian. ( ) This is the vet that I plan to use. Name of practice: Name of doctor: Address: City, State: Phone # (include area code) Please contact all references and give them permission to talk to a TTR representative. I certify that the above information is true and accurate to the best of my knowledge, and that I have not willfully concealed any information that may hinder my ability to properly care for a dog. I certify that I have never been convicted of animal cruelty, neglect, or abandonment by a court of law or other governmental authority. I understand that submission of this application is not a guarantee of adoption through TTR. I consent for a TTR representative to contact my references, including my veterinarian. Name:Date: End copy here. |
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