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Dog Days Adoption Application

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					                      Dog
Days
Adoption
Application

                                                            

                             

A
501(c)(3)
not‐for‐profit,
all‐volunteer‐run
corporation

                                                       (800)
653­3134

                                      info@godogdays.org

|

www.godogdays.org

                                                          

                                                                    

  PLEASE
NOTE:
This
application
will
be
given
to
the
rescue
responsible
for
the
dog
named
below.

 Dog
Days
does
not
manage
or
coordinate
adoptions,
only
adoption
events.
The
rescue
reserves
the

       right
to
approve
or
deny
any
adoption.
This
application
is
NOT
an
adoption
contract.




DATE________________

TIME
_____________
Name
of
dog
______________________________________________________



To
adopt,
you
must:



___


be
at
least
21
years
old





















































































                        ___


have
the
knowledge
and
consent
of
all
adults
living
in
your
home
















                        ___


be
able
&
willing
to
spend
the
time
and
money
needed
to
provide

                        








the
dog
with
training,
vet
treatment
and
proper
care
























Completion
of
this
application
doesn’t
guarantee
adoption
approval.
Please
print
legibly
and
clearly

and
complete
all
pages.
Thank
you!



Name
of
applicant_______________________________________________
Birth
date_____________







































Spouse/partner______________________________________________________________________________________________ 



Address_______________________________________________________________________________________________________ 



City_____________________________________________



State________



ZIP
 _______________________________________ 



Tel
#:

Home
______________________Work
_____________________
Cell
 _________________________________________ 




E‐mail
address:
______________________________________________________________________________________________ 



Applicant’s
place
of
employment
________________________________
Occupation
____________________________ 



Spouse/partner’s
place
of
employment
____________________________
Occupation
 ________________________ 



Hours
applicant
works
per
day

_____________









From______
Am
/
Pm




To
______
Am
/
Pm




Hours
spouse/partner
works
per
day_____________



From
______Am
/
Pm



To
______
Am
/
Pm



Have
you
ever
owned
a
dog?


YES
_______


NO
________
If
yes,
do
you
still
have
it?
 _____________________ 



If
not,
what
happened
to
the
dog?
 _________________________________________________________________________ 



Have
you
ever
given
a
dog
to
a
shelter
or
to
someone
else?
Yes
____
No
_____
If
yes,
please
explain:



__________________________________________________________________________________



Have
you
ever
had
a
pet
euthanized?
Yes
________
No
_______
If
yes,
please
explain:
______________



____________________________________________________________________________________



Why
do
you
want
to
adopt
a
dog/puppy?
______ __________________________________________________________             



___________________________________________________________________________________



Will
the
dog
be
kept
as
a
(please
check
all
that
apply):
family
pet_____

guard
dog
_____






playmate
for

children_____

companion_____

personal
protection_______

other_________________





Why
did
you
choose
this
particular
breed/mix
of
dog?
__________________________________________________             



___________________________________________________________________________________



Was
your
last
dog
obedience‐trained?
Yes
_____
No
_____
Doesn't
apply
______



Is
someone
home
during
the
day?
Yes
_____

No
_____
If
yes,
who?
 ______________________________________            



Where
is
the
adopted
dog
to
be
kept?


Daytime_________________
Evening
 ______________________________             



Where
will
the
dog
sleep
at
night?
________________________________________________________



Do
you
have
a
yard?
_______

If
yes,
how
large?
____________Is
your
yard
fenced
in?
 _____________________          



Is
the
yard
fenced
in
completely?
______


How
high
is
the
fence?
_______

Is
there
a
gate?
 _____________          



If
it
is
not
fenced
in,
how
will
the
dog
be
confined
outside?
 _____________________________________________        



 ________________________________________________________________________________________________________________   



Do
you
have
a
dog
door?
Yes
____
No
____


If
yes,
where
does
it
lead
to?
_______________________



Will
the
dog
be
tied
up
sometimes?

Yes
____
No
_____

If
yes,
when?
 ____________________________________          



___________________________________________________________________________________



Will
the
dog
spend
any
time
in
the
garage?
Yes
___No___
If
yes,
please
explain: ________________________            




 ________________________________________________________________________________________________________________   



Will
the
dog
spend
any
time
in
the
basement/cellar?
Yes
___No___
If
yes,
please
explain:_____________               




 ________________________________________________________________________________________________________________   





Do
you
have
a
pool?

Yes
____
No
____





If
yes,
is
there
a
fence
around
the
pool?


Yes
___

No_________         



If
your
new
dog/puppy
is
not
housebroken,
what
method
will
you
use
to
train
him/her?
___________ 



 ________________________________________________________________________________________________________________ 



Will
you
keep
the
dog
up‐to‐date
on
vaccinations?
Yes
_____
No
_____



Will
you
keep
the
dog
on
all‐year
Heartworm
prevention?
Yes
______
No______



Will
you
keep
the
dog
on
all‐year
Frontline/Advantix
(anti‐flea/tick
treatment)?

Yes_____
No______



If
you
drive
a
pickup
truck,
will
you
allow
the
dog
to
ride
in
the
back?
Yes
____
No
____
N/A
______



If
you
go
away
for
a
few
days,
or
on
a
vacation,
who
will
take
care
of
the
dog?
 _______________________ 



____________________________________________________________________________________



What
will
happen
to
the
dog
if
you
die? ___________________________________________________________________ 



WHO
in
your
household
will
exercise
this
dog
EVERY
DAY?
 ____________________________________________ 



How
much
exercise
will
this
dog
get
every
day?
By
exercise
we
mean
a
person
walking,
jogging,

biking,
rollerblading
with
the
dog.
Time
running
around
the
yard
does
not
count.




Hours
/
day_________
Days
/
week
_______
Where
will
you
exercise
your
dog?___________________________ 



Dogs
can
live
15
years
or
longer.
Can
you
commit
to
caring
for
this
pet
that
long?
 ___________________ 



What
will
you
do
with
the
dog
if
you
have
to
move?
_____________________________________________________ 



What
will
you
do
with
the
dog
if
you
have
a
baby?
 ______________________________________________________ 



We
strongly
encourage
adopters
to
take
out
pet
insurance.
For
a
modest
monthly
fee,
most
vet
bills

will
be
covered.
Do
you
agree
to
take
out
pet
insurance
YES_______
NO
_______



If
NO,
please
explain:
________________________________________________________________



Properly
cared
for
dogs
can
cost
north
of
$1,500/year.
This
includes
yearly
vaccinations
&
vet

checkups,
dog
supplies,
potentially
needed
training,
possible
boarding,
and
good
quality
food.

Furthermore,
unforeseen
medical
expenses
for
illness/accidents
can
costs
thousands
more.









Are
you
FINANCIALLY
ABLE
to
spend
this
kind
of
money
on
this
dog
if
required?
YES___

NO_______ 



Are
you
COMMITTED
to
spend
this
kind
of
money
on
this
dog
if
required?


YES_____


NO ___________ 






What
type
of
food
will
you
feed
this
pet?
 _________________________________________________________________ 



Is
any
household
member
allergic
to
animals?
______
If
yes,
how
will
you
deal
with
reactions
to
this

pet?



 ________________________________________________________________________________________________________________ 



How
many
adults
in
your
home?
_______


How
many
children?
______


Ages:
___________________________ 







How
does
your
spouse/partner
feel
about
adopting
this
dog? __________________________________________ 



Will
you
work
out
bad
habits
the
dog
may
have?
(barking,
chewing,
house‐soiling,
jumping,

mouthing,
aggressiveness,
etc.)

Yes
____

No
_____




Will
your
dog
go
to
work
with
you?
No
____
Yes
____
Retired

_____
Work
from
home
__________________ 



How
long
will
your
dog
be
without
human
companionship?

Hours
/
day_______

Days
/
week_______ 



Describe
where
and
what
the
dog
would
be
doing
on
a
typical
day:



Morning
to
noon:
 ___________________________________________________________________________________________ 



 ________________________________________________________________________________________________________________ 



Noon
to
5pm:
________________________________________________________________________________________________ 



 ________________________________________________________________________________________________________________ 



5pm
to
midnight:
 ___________________________________________________________________________________________ 



 ________________________________________________________________________________________________________________ 



Are
you
willing
to
take
responsibility
for
this
dog
for
the
next
15
years
or
more?

Yes______
No
 _____ 



If
no,
explain: ________________________________________________________________________________________________ 



What
provisions
will
you
make
for
the
dog
should
you
become
unable
to
care
for
him/her?




 ________________________________________________________________________________________________________________ 



How
will
you
deal
with
any
bad
habit?

On
your
own______
Hire
a
trainer
____Group
classes
 _________ 



Will
you
be
bringing
your
dog
to
obedience
classes?


Yes
______


No
______



Do
you
own
or
rent
your
home?
__________
How
long
have
you
lived
at
your
current
address?
_______ 



Do
you
live
in
a:

House
____
Apartment
_____
Condo
____
Townhouse
____
Other
____
(explain)



If
you
rent,
provide
name
and
telephone
number
of
your
landlord
‐
(REQUIRED)



Name:
_____________________________________________

Telephone:

____________________________________________ 



If
you
rent,
please
show
us
the
part
of
your
lease
where
you
are
allowed
to
have
pets,
the
number

allowed
and
any
limitation
in
size
weight,
if
any.
If
pets
are
not
mentioned
in
your
lease,
please
ask

us
for
the
“Permission
to
Have
Pets”
form
and
have
it
signed
by
your
landlord
and
fax
it
to
us.



      If
you
own,
you
must
provide
proof
of
ownership
by
a
copy
of
your
Real
Estate
Tax
Bill,
or
by

      showing
us
your
mortgage
prior
to
paying
adoption
fees.
Owners
of
condos
or
townhouses
must

      also
provide
a
copy
of
the
condo
association’s
by‐laws
indicating
pets
are
allowed,
the
number

      allowed
and
any
limitations
in
size
or
weight,
if
any.

      

      Please
provide
references
of
two
people
(not
in
your
family)
who
have
known
you
5
years
or
more:

      

      Personal
Reference:
_________________________________________
Phone
# _____________________________________ 

      

      Personal
Reference:
_________________________________________
Phone
# _____________________________________ 

      

      Present
and
Former
Veterinarians


      

      Name
of
your
PRESENT
Veterinarian
&
Hospital:
________________________________________________________ 

      

      City
and
phone
number
(Present
Vet): ____________________________________________________________________ 

      

      Name
your
pet
records
are
under
at
your
present
vet
(if
different
than
applicant):___________________ 

      

      Name
of
your
FORMER
Veterinarian
&
Hospital:
 ________________________________________________________ 

      

      City
and
phone
number
(Former
Vet):
 ____________________________________________________________________ 

      

      Name
your
pet
records
are
under
at
your
former
vet
(if
different
than
applicant): ___________________ 


     

     Give
us
information
about
all
the
animals
alive
and
currently
living
in
your
household:

                       Dog/Cat/                              Spayed
/
                    Vacci‐    Dog‐
    Name
of
Pet
                      Breed
        Sex
                  Age
 Weight

                        Other
                               Neutered?
                  nated?
 licensed?


                     
            
              
        
              
     
        
       


                       
             
               
         
              
      
         
         


                       
             
               
         
              
      
         
         

     

     Give
us
information
about
the
last
3
animals
that
you
no
longer
have
(deceased
or
otherwise):

                                                                                            If
dead,

     Date
of

                       Dog/Cat/                               What
happened
to
pet?


    Name
of
Pet
                      Breed
        Sex
                                     age
at
      death
or

                        Other
                                If
dead,
how
did
it
die?

                                                                                             death
     surrender


                     
            
              
         
                             
             


                     
            
              
         
                             
             


                     
            
              
         
                             
             

     

     Where
did
you
hear
about
DOG
DAYS
and
the
dog/puppy
for
adoption?
 ______________________________ 

     

     Are
you
familiar
with
local
animal
control
laws?

Yes
_____
No
_____

     

     Additional
comments
from
applicant:
 ____________________________________________________________________ 



 ________________________________________________________________________________________________________________ 



 ________________________________________________________________________________________________________________ 



 ________________________________________________________________________________________________________________ 





                                 PLEASE
READ
CAREFULLY
BEFORE
SIGNING

                                                   

FEES:

Adoption
fees
are
set
by
each
rescue
but
not
to
exceed
$320.00.
Fees
go
towards
off‐setting

the
cost
of
the
spay/neuter
surgery,
Rabies/Distemper/Parvo/Bordetella
vaccines,
micro‐chipping,

assessment
by
trainer
and
boarding
costs.
All
donations
above
this
amount
are
very
welcome,
and

greatly
appreciated,
as
our
costs
per
dog
are
greater
than
the
adoption
fee.
In
addition,
we
rely
on

donations
to
be
able
to
save
the
next
dog



HOME
VISITS:

Rescues
will
perform
either
a
pre‐adoption
or
post‐adoption
home
visit
or
both.





USE
OF
DOG:
You
agree
that
the
dog
will
be
adopted
as
a
house
pet
and
companion
and
is
not
to
be

kept
kenneled,
chained
up,
tethered,
on
a
cable
run
or
penned
outside,
or
used
as
a
guard
dog
or
for

personal
protection.
The
rescue
always
reserves
the
right
to
reclaim
the
dog
if
it
feels
the
dog
is
not

being
fed,
housed
or
cared
for
to
its
satisfaction.
If
you
are
unable
to
care
for
this
dog,
he/she
must

be
returned
to
the
rescue
designated
in
your
contract.



COPY
OF
DRIVER’S
LICENSE
(or
other
form
of
official
ID)
IS
REQUIRED




This
application
is
designed
to
help
us
determine
if
the
adoption
is
in
the
dog’s
best
interest,
and
to

assist
you
in
finding
a
pet
compatible
with
your
lifestyle.
An
unwise
adoption
can
result
in
an

unpleasant
experience
for
adoptive
families
and
may
ruin
the
pet
for
further
adoptions.

We
hope

you
will
agree
that
the
pet’s
welfare
must
be
our
foremost
concern.



I
understand
the
above
questions
and
I
authorize
investigation
of
all
statements
contained
in
this

application.

I
understand
that
misrepresentation
or
omission
of
facts
is
cause
for
denial
of

adoption.

By
signing
this
application,
I
am
stating
that
the
above
mentioned
is
true.



Your
Signature
____________________________________________________
Date:
 ___________________________________ 








For
internal
use
only:



Final
comments:
 _______________________________________________________________________________________________________



 ___________________________________________________________________________________________________________________________



 ___________________________________________________________________________________________________________________________





_____
Approved







_____
Denied








By_______________________________
Date __________________________________________




















































































































































































				
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