New Hope Dog ResQ Adoption Application

Valerie Mackett 807-624-8686 val@newhopedogrescue.net

www.newhopedogrescue.net

Applicants name: Address: Occupation: Phone number(s): Email address:

Date:

Please fill out this form completely; failure to answer one or more questions may result in your application being rejected. Completion of this application does not guarantee adoption of a New Hope dog. 1. Name of desired dog/puppy you are applying to adopt.

2.

How many adults in the household?

3.

Names/Ages of Children, if any:

4.

Type of Dwelling? House,

Condo,

Apt.

Other

5.

Do you rent or own?

6.

If renting, do you have your landlord's permission to have a dog? Provide landlords name and phone number:

7.

What are your primary reasons for wanting a dog?

8.

If you have children, please describe their previous experience with dogs:

9.

Do you have any other pets? Please be specific with breeds and ages? Are the other pets spayed or neutered? Are their vaccinations up to date? What is/are the general disposition of your other pet(s)? Please include details of previous dog ownership.

10.

Is there anybody home during the day? Yes If so, who?

No

11.

When will the dog be inside?

12.

When will the dog be outside?

13.

About how many hours a day will the dog be left alone?

14.

Where will the dog stay when he/she is home alone? (Please be as specific as possible; i.e., run of the house, a specific room, a crate, etc.)

15.

Is there a yard? Is it fully fenced? Is the fence in good repair? Please be specific. Type of fencing? (Chain link, wood, block wall, etc.) Height of fence:

16.

Where will the dog/puppy be during the day and during the night (i.e. where will the dog/puppy sleep?

17.

Will the dog/puppy have access the basement and upstairs? Will the dog/puppy have access to the garage?

18.

What rooms are off limits to the dog?

19.

Are there any hazardous materials lying around? Anything of concern?

20.

Does anyone in the household smoke?

If so, do they smoke in the house?

21.

Preferred level of exercise with dog?

22.

Describe a regular week (how many walks, etc)? Any off-leash activities?

23.

What kind of food will you feed the dog? Brand of kibble/canned:

24.

Will you be taking the dog/puppy to obedience classes?

25.

Are there any special needs, unusual circumstances or concerns that we should consider?

26.

When you go on vacation, who will care for the dog? (Friend, kennel, dog sitter, etc)

27. 28. 29. 30. 31.

Do you have a regular vet? Provide name: Who will groom and bathe your dog? How would you discipline your dog if he or she misbehaved? How would you train this dog? How would you rate your level of dog owning experience?

32.

Pets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, shelter and exercise for your new pet?

33.

Are you able to make a long-term commitment to care for you pet for its entire life span, which could be as much as 10 to 20 years?

34.

Why are you interested in adopting from a rescue?

35.

Please provide a pet reference (eg. veterinarian, friend, etc, who can comment on your suitability as a dog owner Note: reference should not be a relative)

36.

Please read and initial each statement below:

I understand that a home visit is required prior to final placement _______ I understand that a home visit does not guarantee placement ________

I CAN make a donation of at least $___ to help rescue, provide medical

care, spay and neuter, board and place other abandoned dogs. (Inability to make a donation does not disqualify an applicant from consideration.) I understand that any donation or contribution is a gift freely given, not a purchase price for the dog _________ I CAN NOT make a donation to help rescue, provide medical care, spay and neuter, board and place other abandoned dogs. (Inability to make a donation

does not disqualify an applicant from consideration.) I understand that any donation or contribution is a gift freely given, not a purchase price for the dog _________

Please list the name of the dog you're interested in again, and tell us why you're interested in this particular dog

37.

COMMENTS:

Applicants signature:

NOTE: completed application can be emailed to val@newhopedogrescue.net or a hardcopy can be mailed to New Hope Dog ResQ @ P.O. Box 10191, Thunder Bay, ON P7B 6T7