Animals Rule Rescue

Name *

Address, City, State, Zip *

Age

Home number *

Cell phone

Email address *

What is your Occupation?

Length at Occupation.

How many days a week & hours a day do you work?

Name of Spouse, Significant other, partner, or roommate:

Select Relationship of this person: Select Spouse Significant Other Partner Room mate

Partner's Email Address:

Partners Cell Number

What is your partner's occupation?

Partner's length at occupation?

How many days a week & hours a day do they work?

Who would keep the pet if the relationship ends?

In General, why do you want a dog?

Is every member of the family in agreement to adopt this pet? Yes No

If you had to suddenly relocate or had other drastic lifestyle changes that made it hard to keep your new pet what would you do with him/her?

What will you do if you can no longer keep your rescue dog?

Are you prepared to make a commitment of 10-16 years? Yes No

What type of home do you have? House Condo Apartment Townhouse Duplex Mobile Home Boat

Do you own, rent or lease your home? Own Rent Lease

Landlords Name

Landlord's Phone number

How long have you lived at your current address:

Is your yard fenced? Yes No

What type of fencing do you have?

Height of back fence?

Height of Front Fence?

Do you have a pool? Yes No

Is there a fence around your pool? If yes, please provide height.

How many adults (over 21) live at this residence?

How many children (under 21) live at this residence?

If applicable, Names & ages of all children

Is anyone allergic to cats or dogs? Yes No

Do you have a dog door? Yes No

If no, will you install one?

Full name

Relationship to you?

Their phone number?

Will your dog be a: Family Pet
Home Protection
Children's dog
A Gift
Work Protection
Companion for other pet
Guard Dog

What kind of outside shelter do you have?

Where will your dog sleep, be specific

Do you have plans for your pet, should it outlive you, to assure it won’t end up in the shelter? Yes No

Name of new owner:

Phone of new owner:

Have you ever given up a pet before? Yes No

If yes, where did it go?

Have you ever lost a dog or had one stolen? Yes No

If yes, explain:

Do you have a vet? Yes No

Current vets name, address, and phone number:

Who will be responsible for feeding, housebreaking & training?

If you rescue dog is not housebroken, how will you house train it?

How will you deal with potential issues of your dog such as; fear, chewing, digging, barking, separation anxiety, walking on leash, etc.?

Do you plan to take this dog to obedience class? Yes No

Is someone home during the day? (Please explain)

How many hours a day will your dog be left alone, explain

When I am home this pet will be kept (explain)

When I am not home this pet will be kept (explain)

Where will your dog spend his day (explain)

Name the dog breeds you have owned since you were 21.

How long did you own them and where are they now?

Do you have a dog now? Yes No

Please list breed, sex & age of current dogs.

Are they spayed/neutered? Please Choose Yes No

Explain why pet is not fixed.

What other pets do you have?

Are they spayed or neutered? Yes No

Explain why other pets are not fixed:

If you no longer have your pet, what happened?

Is there anything else that you would like for us to know?

How did you hear about us or specific website?