Dog Adoption/Foster Application

The following information is requested so that we can assist you in the selection of your new pet. This form and consultation with a Lovin' Life Rescue Representative are designed to help you find the pet most compatible with your lifestyle.

General Information

Interest:	Adoption Fostering
Dog's Name:

Applicant / Co-Applicant Information

First Name:
Last Name:
DOB:
Address (Line 1):
Address (Line 2):
City:
State:	AL AK AR AZ CA CO CT DC DE FL GA HA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY
Zip Code:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Do you own your home or rent?	I own my home Rent
How long have you lived at this address?
Any plans to move in the near future?
Landlord / Condo Board's Name:
Landlord / Condo Board's Phone:
How did you hear about Puppy Love / Love Cats Pet Rescue?

Employment Information

Employer:
Position Held:
Address:
City:
State:	AL AK AR AZ CA CO CT DC DE FL GA HA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY
Zip Code:

Family / Household Information

Number of adults in the household and what is the relation:
Have all the adults in the household agreed to this adoption?	Yes No
Number of children in the household:
Ages of children:
Have the children had pets before?	Yes No
Do you expect your current family situation to change?	Yes No
Is anyone in the household allergic to pets?	Yes No
Who?
Why whould you like to adopt an animal from us? (Check all that apply)	Companion for self Companion for child To breed Companion for another pet Gift Companion for another household member Watchdog / Protection

Pet Information

How long have you been looking for a pet?
Is this your first pet?	Yes No
If you have had pets in the past of currently have pets, please tell us about them: Name Breed / Mix Age Gender Spayed or neutered? Tail-dock, Ear-crop? Vaccines Current? *Do they still live with you? M F Yes No Yes No M F Yes No Yes No M F Yes No Yes No M F Yes No Yes No M F Yes No Yes No *If deceased, please indicate so and approximate the age of death.
If you've owned a dog, did you provide obedience training for it?	Formal Training Yes, Informal Training No
Have you ever given an animal away or relinquished an animal to a shelter? If yes, what were the circumstances?
Under what circumstances would you (or have you) euthanize(d) a pet?

Veterinarian Information

Veterinarian's Name:
Veterinarian's Phone:
What annual vaccines will your pet receive?
When was your current pet's last visit to a Veterinarian and why?

New Pet Information

What characteristics are most important to you? (Check all that apply)	Good with all dogs Housebroken Good with some dogs Mellow Good with cats Energetic Good with children Other (please explain)
What will you feed your pet and how often?
How much time are you prepared to allow for your new pet to adjust to your home?
Are you prepared to spend several weeks or perhaps months waiting for your new pet to adjust to their new environment and for you to adjust to your new pet?	Yes No
How do you plan to introduce your new pet to other animals and/or people in the household?
Are you able to afford a bill of $500 (or more) for emergency veterinary care?	Yes No
What will you do if the vet bill exceeds this amount?
Are you committed to providing a responsible home for your pet's entire life (15+ years)?	Yes No
If you have to move, what do you plan to do with your pet(s)?
Who in the household will be the pet's primary care giver?
When you are out of town, who will be the dog's primary care giver?
In case of emergency, who will care for your dog?
Where will the dog be kept during the day?
During the night?
Are you willing and able to exercise the dog on a regular basis?	Yes No
How many times do you plan to exercise your dog (this includes playing fetch, walks, jogs, etc.):	at least once a day twice a day three or more times a day
Are there times when the dog will be tied up?	Yes No
If yes, please explain:
How many hours per day will your dog be left alone without human companionship?
If your new dog is not housebroken, what method of house training do you plan to use?
Do you have a fenced in yard?	Yes No
If yes, approximately how high is the fence and what type?
If you have a garage, will the dog spend any amount of time in the garage?	No, I don't have a garage I have a garage, but it will not be used for the dog Yes, the dog will occasionally stay in the garage
What is the longest period of time you would leave your pet unattended outside?
Are you willing to enroll your dog in obedience training if necessary?	Maybe Yes No

What would you do if your dog develops a problem with...

Digging:
Excessive Barking:
Biting / Play Biting:
Destroying Furniture or Clothing:
Shedding Excessive Hair:
Urinating/Defecating in Unacceptable Places:
Keeping You Awake at Night:
Separation Anxiety:
Aggression with People or Other Animals:
Is there anything else you'd like us to know?

References

Please list 3 personal references below. Name Relationship Phone Number