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ResQ 4 Paws Staff Only Dog Name Dog ID_ License_ Date Obtained

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ResQ 4 Paws Staff Only Dog Name Dog ID_ License_ Date Obtained Powered By Docstoc
					ResQ 4 Paws Staff Only

Dog Name: _____________________ Dog ID#: _______________________ License#: ______________________ Date Obtained: __________________ Obtained From: _________________ www.resq4paws.org

Adoption Application
ResQ 4 Paws ∙ Po Box 388 ∙ Ortonville, MI 48462 ∙ (248) 627-5504 ∙ resq4paws@yahoo.com Date: ____________ Name of Adopter(s): _____________________________________________________________ Age(s): __________ Driver’s License #: _______________________________________________ Street Address: __________________________________________________________________ City, State, Zip: __________________________________________________________________ E-mail address: __________________________________________________________________ Can ResQ 4 Paws contact you by e-mail for Resq 4 Paws related information? ________________ Home Phone: ( )_______________________ Mobile Phone: ( ) _______________________ ) ________________________ ) ________________________ Primary Adopter Employer: _________________________________________________________ City: ___________________________________ Work Phone: ( City: ___________________________________ Work Phone: ( Best Time to be Contacted: _________________ Which dog are you interested in? ____________________________________________________ If no specific dog, what age/sex/breed? ___________________________________________ Do you prefer a non-shedder? ______________________________________________________ Why do you want to adopt a dog? ___________________________________________________ _______________________________________________________________________________ Do you consider yourself / family to be active in such a way that would include a dog? ___________ _______________________________________________________________________________ What dogs/cats do you currently have? Breed: ______________ Breed: ______________ Breed: ______________ Breed: ______________ Sex: ______ Age: ______ S / N Indoor / Outdoor Sex: ______ Age: ______ S / N Indoor / Outdoor Sex: ______ Age: ______ S / N Indoor / Outdoor Sex: ______ Age: ______ S / N Indoor / Outdoor Secondary Adopter Employer: _______________________________________________________

What happened to your animal? _____________________________________________________ _______________________________________________________________________________ If you don’t have a dog or cat now, what dogs/cats have you had in your adult life? Breed: ______________ Breed: ______________ Sex: ______ Age: ______ S / N Indoor / Outdoor Sex: ______ Age: ______ S / N Indoor / Outdoor

How do your dogs/cats get along with others? __________________________________________ Ever train in obedience? ___________________________________________________________ What discipline method do you use, how do you correct you dog(s)? _________________________ _______________________________________________________________________________ Willing to train in obedience? ________________________________________________________ What dog food do you use? _________________________________________________________ How often? ___________________________ Do you use Heartworm Preventative? Yes / No Have you ever bred a litter? Yes / No Have you ever adopted/rescued a dog/cat before? Yes / No Have you ever returned a dog to a shelter? Yes / No If Yes, please explain: __________________________________________________________ _______________________________________________________________________________ Name of Veterinarian: ______________________Telephone: ______________________________ Address: ________________________________________________________________________ City, State, Zip: __________________________________________________________________ Personal Reference #1: _____________________Telephone:______________________________ Address: ________________________________________________________________________ City, State, Zip: __________________________________________________________________ Personal Reference #2: ______________________Telephone:____________________________ Address: ________________________________________________________________________ City, State, Zip: __________________________________________________________________ Size of Yard? ______________ Completely Fenced? Yes / No Fence Height? _______________ Type of Fence? __________________________________________________________________ If you do not have a fence how will the dog be let in and out? ______________________________ _______________________________________________________________________________ Do you have a dog kennel? Yes / No What Type? _____________________________________ What kind of accommodations do you have for the dog in the hot/cold weather? ________________ _______________________________________________________________________________ Is anyone home during the day? _____________________________________________________ From who? (Name & Number):_____ _______________________________________________________________________________ Wet / Dry What kind? _____________________________

How many hours will the dog be left alone? ______ Where will it stay? _______________________ Do you own or have you used a crate? _________________ Metal / Plastic What are the ages of children in contact with the dog? ____________________________________ Please describe any neighbors that the dog would be involved with (do they like dogs?, have children (ages), have dogs, cats? ____________________________________________________ _______________________________________________________________________________ Is there asthma or allergies in the household to dogs or cats? ______________________________ If yes, how severe? ____________________________________________________________ Do you own or rent? _________ How long at address? __________________________________ Type of home (condo, trailer, townhouse, etc..): ________________________________________ Are there any pet restrictions? ______________________________________________________ Are you willing to have a ResQ 4 Paws member visit your home before and after adoption? ______ Name and number of park manager: _________________________________________________ If you rent, a letter of permission from your landlord will be required prior to adoption. Name of Landlord: ____________________________________________________________ Address: _____________________________________________________________________ City, State, Zip: _______________________________________________________________ Landlord’s Phone: _____________________________________________________________ Do all parties in the household want a dog? ____________________________________________ Adopted pets need adjustment time, are you willing to give the new dog at least one month trial period to ensure proper adjustment? __________________________________________________ _______________________________________________________________________________ What would, in your opinion, constitute a reason for not keeping the dog? ____________________ _______________________________________________________________________________ We are always in need of temporary homes for our rescue dogs. Would you be willing to foster a homeless pet if it is compatible with your lifestyle and other pets? __________________________ _______________________________________________________________________________ For how long? _________________________ Until placed? ______________________________ I/We understand that if we cannot keep the dog it will never be sold, given away, traded, abandoned, or otherwise disposed of to any person(s), dealer, retailer, auction, institute or other entity for any reason. I/We understand the dog MUST be returned to ResQ 4 Paws, no exceptions. I/We agree that we will notify a member of ResQ 4 Paws in a timely manner to make arrangements for the return of the dog. I/We agree I/we will humanely house and care for the dog until arrangements can be made with ResQ 4 Paws. If I/We do not return the dog to ResQ 4 Paws we agree to pay $1000 to ResQ 4 Paws for violation of this contract. Date: ______________________ Primary Adopter: _________________________________________________________________ Secondary Adopter: _______________________________________________________________ ResQ 4 Paws Representative: ______________________________________________________


				
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