Good Buddies Canine Rescue

Adoption Application

Please answer each question listed below. By filling out the application completely, it helps us to best match a pet to your lifestlye and experience.

Name of dog:

Breed:

Do you and your family members understand that we do not provide a “trial” period for adoption, and that our minimum requested adoption donation of $150 for adults and $160 for puppies (5 months and under) is non-refundable? YesNo

E-mail: *

Your Full Name: *

Physical Address: *

City: *

State: *

Zip: *

Cell Phone:

Home Telephone Number:

Best time to reach you? MorningAfternoonEveningAnytime

Preferred Number? HomeCell

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Do you have any children in the home or children that frequently visit? YesNo

Please list the ages of the children:

Do you own or rent your home? OwnRent

Do you have consent to adopt a dog of this type/size from your landlord or leasing office? YesNo

Please provide contact information for your landlord or apartment leasing office:

Do you have a yard? YesNo

Is your yard fenced? YesNo

If you do not have a fence, how do you plan to handle your pet's outdoors activities?

Is your fence: Standard chain linkPrivacy fence (at least 6' high)Invisible fenceOther

Do you have any known outside dangers (ie uncovered pool, fence damage, poisonous plants) to a dog? YesNo

Cities, HOA’s, and some renting situations impose limitations on the number of animals, breed, and size of the animals. What are any of these known limitations?

Who will be the primary caretaker of the dog?

Is every family member in agreement about the decision to adopt this type of pet? YesNo

If no, why?

Does anyone living in your household have known allergies to dogs? YesNo

Do you have any cats? YesNo

How many cats?

Do you have any small animals or birds? YesNo

If you own other pets, are they spayed/neutered? * YesNoN/A

If no, why? *

Do you have any dogs? YesNo

DOG #1 - Please list the name, breed, age, gender, and general temperament below:

DOG #2 - Please list the name, breed, age, gender, and general temperament below:

DOG #3 - Please list the name, breed, age, gender, and general temperament below:

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Why are you interested in adopting the specific dog listed at the beginning of the application? *

If a dog other than the one specified above seems suitable in all other ways, would you consider adopting a different: GenderColorAgeSize

Do you accept that animals placed in a rescue may have behavioral issues that surface at a later time, and are you willing to help work with the animal to correct any basic issues if they appear after adoption? * YesNo

Under what circumstances would you ask to return a dog? *

Have you ever given up a pet? * YesNo

If yes, why?

What did you do with the pet?

Do you have a crate? YesNo

Would you be willing to crate train a dog? YesNo

On average, how many hours would a dog spend alone during the week?

What provisions could you make for a dog while you are out of town? *

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Would you be willing and able to provide basic training? (House training, sit, stay, no jumping, etc.) YesNo

Would you be willing to enroll an adopted dog in basic obedience classes if needed? YesNo

Have you ever attended dog training classes? YesNo

Did you complete them? YesNo

Please list any other dog-related experiences or skills that would be beneficial in your application process:

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We do call all references listed. By typing the contact information for your references you give your permission for your current pet's record(s) to be inquired about by Good Buddies Canine Rescue. If you omit this portion your application will be discarded.

Please list the name and contact information for your current veterinarian:

Also, please list a non-family reference that we may contact:

(If you do not have a veterinarian because you do not currently own any pets, please list 2 non-family references that we may contact IN REPLACEMENT OF the above requirements):

All of the above information I have given is true and complete. I agree to follow all the Rules and Procedures of Good Buddies Canine Rescue and I understand that all dogs are required to be altered and kept as primarily indoor pets. I will not hold Good Buddies Canine Rescue responsible for any damage, injury, or harm caused directly or indirectly to any person or property by any animal I may decide to interact with under the care of Good Buddies Canine Rescue. Good Buddies Canine Rescue reserves the right to refuse any applicant without explanation. By typing my name in the box below I am submitting an electronic signature, and I agree to the conditions listed above. *

Date: *