Copy the application below and then click here.
Please be honest when completing this application. There are no wrong answers. The questions are designed to help place our dogs in the right homes.
Name of dog you are interested in, if applicable:__________________
TELL US ABOUT YOURSELF:
Name (primary owner of the dog)_________________________ Age____________
Home Address _________________________________________________________
City, State_________________________________________Zip ____________
Home Phone _________________________ Cell Phone: ________________________
How long in current home? __________________________________________
How long at current job?_____________________________________________
Name (co-owner of the dog)______________________________ Age __________
Email Address ____________________________________________________
Cell phone:____________________________ Alt Phone:_______________________
How long in current home?________________________________________________
How long at current job?________________________________________________
Number of People in household, Total: _____
Number of Adults _____
Number of Children _______ Age(s) ________________
Does anyone in the house smoke? Yes ____ No _____
Is everyone in the household in agreement about adopting a new pet?
Yes ___ No ___
Does anyone in the household have any known animal allergies?
Yes ___ No ___ If yes, please specify _____________________________________
TELL US ABOUT YOUR HOME:
What type of dwelling is it?
House _______ Condo_________ Townhouse_________ Apt________
Is your yard fenced in? Yes _____ No______
If so, what is the height ____________
Type of fencing___________________
Are there any breed/size restrictions where you live (e.g., by apartment management, condo or homeowner’s association)? Yes_____ No______
If so, what is restricted? _____________________________________________
If you rent, please provide your landlord’s name & contact information:
Name____________________ Phone______________ Email_____________________
By providing your landlord’s information, you are giving Dogma Pet Rescue permission to contact your landlord.
If you rent, have you already paid a pet deposit (if required)? Yes_____ No______
TELL US ABOUT YOUR PETS:
Is the dog you are interested in adopting going to be your first pet? Yes____ No_____
Did your family have pets when you were growing up: Yes_____ No______
If the dog is not going to be your first pet, please complete the following:
Please list all cats & dogs currently in your household:
CAT OR DOG
BREED (if dog)
Please list all cats & dogs you have owned during your adult life:
CAT OR DOG
DURATION CARED FOR/WHAT HAPPENED TO YOUR PET
Please use a separate sheet of paper if you need more spaces.
Have you ever turned an animal into a shelter? If yes, please explain.
Please provide contact information for your veterinarian:
Phone _____________________________ Fax __________________________
What do you know about Heartworms?
By providing your veterinarian’s information, you are giving Dogma Pet Rescue, Inc.
permission to contact your veterinarian. You also are giving permission for your
veterinarian to provide Dogma Pet Rescue, Inc. with a reference.
TELL US ABOUT ADOPTING YOUR NEW DOG:
Where will your new pet be kept (please be specific)
During the day? ___________________________________________________
At night? _________________________________________________________
How many hours during the average day will your pet be alone without a human? ______
If your new pet is a dog, how do you plan to provide exercise for it (check all that apply)?
___ Leash Walk Everyday
___ Will Have Cable Or Dog Run in Yard
___ Will Be Free To Run in Fenced Yard
___ Will Have Supervised Access to unfenced yard
___ Will be Free to Roam Around
___ Will Take Dog to Dog Park
How long have you been considering adopting an animal? __________________
In the event you/someone in your home were unable to care for your adopted pet,
who would be responsible for the animal’s needs? ___________________________
Please indicate age, breed and other desired characteristics that you are looking
for in your new dog: ___________________________________________________________
Please tell us why you are interested in adopting? Check all that apply:
___ Companion for Self ___ Companion for Family
___ For Breeding ___ Gift
___ For Protection ___ For Child
___ Replace Previous Pet ___ Companion for Other Pet
___ Other, please specify ___________________________________________
Are you prepared to spend several weeks or, perhaps months, waiting for your
new pet to adjust to a new environment? Yes ___ No___
Do you anticipate any major changes in your life that could affect a pet, such as a
move, new baby, change of job/schedule, in the next year? 2 years? 5 years?
Please explain. _______________________________________________________
I certify that the above information is true and understand that false information may
result in nullifying this adoption. Also, if an omission or untruth is discovered after an
adoption takes place, I understand that Dogma Pet Rescue, Inc. reserves the right to
annul the adoption and reclaim the animal. I give Dogma Pet Rescue, Inc. permission to
fully investigate the information provided as well as contact veterinarians, landlords, etc. I
give permission for my veterinarian to release any information asked by a representative
from Dogma Pet Rescue, Inc. If the application passes this review, I agree to a home
visit on a mutually agreed date and time by a Dogma volunteer before an adoption decision is made.
Signature (for electronic transmitting purposes, Date
your typed name will serve as a signature)
Our adoptions are decided on what is the best match for the animal and its potential family,
not on a first come first serve basis. We reserve the right to refuse an adoption.