Rescue Dog Adoption Application

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					Rescue Dog Adoption Application
Please answer every question in order for your application to be considered. Completing an application is not a guarantee of adoption. Name: Address: City: County: Phone: Email: ●Why do you want to adopt this dog? (Please check all that apply) Companion Guard dog Gift For children Family companion (____)______________ Cell (_____)______________ Work (_____) ________________ State Zip:

●Please list ALL of the pets you have had in the past 5 years and those you currently own.
Type/Breed Sex
(Circle one)


Spayed or Neutered


Where is this pet now?
(If pet died, please list at what age and reason)

M F M F M F M F M F M F ●How many adults are in your household?: ●How many children?:

Yes Yes Yes Yes Yes Yes

No No No No No No Ages: Ages:

Yes Yes Yes Yes Yes Yes

No No No No No No

●Has every member of your family agreed to adopting this dog? ●Does any member of your family have allergies or asthma? ●If Yes, please describe: ●Is someone home during the day? Yes No

Yes Yes

No No

(If this has not been discussed at great length, please complete application when that has occurred.)

If so, who?

●How many hours will this dog be alone each day? ●Where will this dog be kept when it is left alone? ●Where will this dog be kept when you are home? ●Where will this dog sleep at night? ●Who will care for this dog when you are on vacation or out-of-town?

Adoption Application Continued
●Do you live in a: ●Do you: Own House Rent Townhome/Condo Other Yard Apartment Duplex Yes Mobile Home No -Landlord Name/Number: Patio Both No fencing in place.

●If you rent, does your Landlord allow tenants to own dogs of all sizes?: ●Do you have a fenced: ●If you do have fencing, what type is it? ●What is the fence height at the lowest point? ●Do you have a pool? Yes No If Yes, is the pool gated?



●If you move (locally, out of state, or out of the country) what will you do with this dog? ●Are you prepared to make a commitment of 6 to 10+ years to this dog? Yes No

●Do the costs of vaccinations, medical care, licensing, grooming, boarding, supplies, and/or general upkeep of your dog present any financial problems for you? (The annual cost associated with providing responsible care to a healthy dog Yes No is approximately $500) ●Which reasons are acceptable for giving up your dog? (Check all that apply) fence jumping biting too active barking ●Have you ever had to give up a pet? ●If your dog gets sick, what will you do? ●Who is your current veterinarian? (name and phone number please): ●Have you ever adopted any animals before? ●If Yes, do you still have this/those animal(s)? Yes Yes No No Yes No If so, when and why? allergy showing teeth illness moving marking in house hides for a week housebreaking accidents chewing/destructive behavior digging non-compatible w/other pets

Your application will be reviewed, along with all others received, by Canine Support Teams, Inc. personnel to insure that the best possible home is selected for this animal. Animals are not adopted solely on a first come—first served basis. The completion of this application is not a guarantee of adoption. Incomplete applications forms are grounds for denial of adoption We Reserve the Right to Refuse the Adoption of any Animal I hereby certify that the above answers are true, to the best of my knowledge, and I understand that if approved, I must sign and abide by an Adoption Agreement. Applicant Signature Date Fax to: 951-301-3605 or Mail to: PO Box 891767, Temecula, CA 92589 or Email to:

************************************************************************************************ FOR OFFICE USE ONLY

Office Use Only Reviewed by: ______ Recommend Adoption Do Not Recommend Adoption

Date Application was received: _____________ Comments:

Time Received: _____________

Visits by applicant: Date: Date: Date:

Approved/Denied by: __________________________________

Date applicant contacted ___/___/___ Contacted by ________________ Comments:

In person


By Phone


Rev. 6/10/2008 PPP Dog Adoption Application.doc

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