Animal Angels Rescue

@ www.ANIMAL-ANGELS.ORG

 

Adoption questionnaire/ Application

 

Thank-you for your interest in adopting one of our foster dogs.

 

Animal interested in (list name)_______________________

 

Date:_______________________________________

 

Applicant’s name:___________________________________________

 

Applicant’s address:________________________________________

 

City________________________ State_______________ Zip_______

 

Phone (home)_________________(cell) _____________________

 

Home E-Mail address: ____________________________________

 

Are you employed? _______ retired _______ student ________

 

          Homemaker __________ unemployed ______________

 

Employer’s name ________________________________

 

          Location _____________________________

 

          Job title ____________________________

 

          Supervisor’s name ____________________

         

          Employer’s number ________________________

 

          May we call _________________

 

Type of residence:

 

house ___ apt ____ condo ____ mobile ____

 

Do you own ________  or rent? ________ 

 

If you rent, name, address, and phone number of landlord.

 

__________________________________________________

 

__________________________________________________

 

If you own, length of time____________________

 

Name of bank holding the mortgage _______________

 

Housing location: within/ outside  city limits

 

Type of street: busy _______ slight traffic ______

                       

country_______

 

How many people are in your household? ____________

 

What are their ages? _____________________________________

 

What is their relationship to you? _______________________

 

Do you have visiting family members e.i grandchildren

 

___________________________________________________________

 

Anyone in the home have allergies or asthma? _______________

 

Does anyone in the home smoke? ____________________

 

What personality /energy level would you like in a dog?

 

_____________________________________________________

 

What breeds interest you? _________________________________

 

What size of dog interests you ? __________________________

 

Does gender matter? _______________________________________

 

Does age matter in your decision ? _______________________

 

Where will the dog live?  inside _______ outside ___________

 

Facilities for pet:

Is your yard fenced? ________ What type of fence?___________

 

Pen ____________ size of pen ___________

 

How many hrs a day will the dog be alone? __________________

 

Where will he stay when unattended?  _______________________

 

How often do you travel? ______________________

 

Where will the dog stay while you travel? __________________

 

If a kennel, name and address ______________________________

 

____________________________________________________________

 

Are you will to obedience train? ___________________________

 

Age group of applicant 18-30 _______ 31-59 ______ 60+ _____

 

If you are under 18, your parents must complete the application

 

Do you currently have pets? ________  If yes, what kind ____

 

_____________________ and what age _______________________

 

Are they spay/neutered? _________________

 

If you currently do not have a pet, have you ever had pets before?___________  How long ago? ________________

 

Did they have health issues ? _____________________________

 

What happened to them? _____________________________________

 

Please provide a veterinarian reference:

 

Name _____________________________________________

 

Address _______________________________________

 

Are you aware that a pet is a large responsibility? ________

 

Can you afford to pay vet bills should your pet become ill or injured? ___________

 

Name an emergency veterinarian clinic near you if the pet

 

becomes ill on Sunday ___________________________________

 

Have you applied with other rescue groups? ________________

 

Names of the organizations _________________________________

 

____________________________________________________________

 

Please provide 3 references. They cannot be family members

 

or roommates. They can be work associates, groomers, vets,

 

or neighbors. We will call these references as part of the

 

application process. Required information of the references:

 

Name ______________________________________________

 

Address _____________________________________________

 

City ____________________State ___________zip ______________

 

Telephone numbers: Home____________________ 

 

                   Cell __________________

 

Name _____________________________________________________

 

Address __________________________________________________

 

City ___________________________state _____ zip ___________

 

Telephone numbers: Home ______________________________

 

                  Cell _____________________________

 

Name ___________________________________________________

 

Address _________________________________________________

 

City __________________________state ______ zip __________

 

Telephone numbers: Home _________________________________

 

                  Cell _____________________________

 

 

By submitting this application, you agree to co-operate with

 

Animal Angels Rescue adoption process. Often there are

 

several qualifying families for one animal. It is our job

 

and responsibility to decide the best match for the dog. We

 

may decide that you are not a good match for that specific

 

animal and that no reason will be given.