APPLICATION TO ADOPT
Name of Dog:
List names and ages of other adults in home and their relationship to you:
Names and ages of Children:
Your occupation and the name of your employer:
Your spouse’s occupation and the name of his/her employer:
Type of Home:
Do you own or rent your home? (select one):
If rent, Landlord name and phone:
Do you have a Yard?
Is it Fenced?
Age, Type, Height of Fence:
Where will the dog stay when you are not at home?:
How many hours a day will the dog be home alone:
Where will the dog sleep at night?:
What do you do with your animals while on vacation?
List other animals currently in your home (breed, age, sex. neutered/spayed, temperament with animals and people.
Please list prior animals and what happened to them. Include breed, age, name.
Reference # 2
Please list 2 personal references. Include name, address, phone and their relationship to you (relative, friend, etc.)
Please list your veterinarians name, address and phone number:
May we contact your veterinarian for a reference?
Are you agreeable to returning the dog to A Tail to Tell, Inc., if you are no longer able to keep the dog?
Please describe any situations that would cause you to give up a pet:
Why do you want to adopt a rescued/ puppy mill dog?
Why do you want to adopt this particular dog?
Are there any other things we should know?
Are you agreeable to signing an adoption contract for the adoption of this dog?
Do you agree to the adoption donation as listed below?
I declare that the information I have provided in this application is complete and correct. I further declare that I am financially and physically able to care for a rescued dog, specifically, a special needs dog. I understand that proper food and veterinarian care may be costly, and I am able and willing to meet the needs of my adoptive dog. I understand the requirement and grant permission for Home Checks at random both prior to and following adoption. I submit that if a Home Check reveals falsification or misrepresentation of any facts on my part, A Tail To Tell, Inc. (the rescuer), reserves the right to either refuse adoption or to nullify the adoption and reclaim said dog from my premises, without reimbursement of the adoption donation. I release A Tail To Tell, Inc. (the rescuer), from any liabilities I may incur from the adoption process.
A Tail To Tell, Inc. reserves the right to decline any application for any reason.