Your age
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Name of the dog(s) you are applying for?
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If you checked "Other" above, please provide name or description of the dog you are interested in:
Street Address
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Mailing Address - if different from above
City, State, Zip
Phone
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(###)
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Caregiver
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Should anything happen to you unexpectedly (car accident, terminal illness, death), who would step in to care for your dog? Please provide name and phone number below.
When are you planning to adopt a dog?
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Applicant 2 Employer - Where do you work? How many hours do you normally work in a day? How many days do you work each week? How long is your commute? How long have you worked with this company?
Names & Ages of everyone living in the home including partner, spouse, boyfriend, girlfriend, children, parents, friends, grandparents or renters. Does anyone have allergies to dogs?
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Is anyone living in your home concerned, afraid, apprehensive, or uncertain about bringing a dog into the house? If yes, please explain.
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Do you Own or Rent your home?
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How long have you lived at this address?
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Please select Months or Years
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If less than 1 year provide previous address & number of years living there. If this was a rental property, provide landlord name & number as well.
Do you live in a condo or neighborhood governed by an Association? If yes, please provide the name & number of someone on the Board of Directors.
Renters - Name of Landlord
Landlord's Phone
(###)
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Do you have permission from your landlord to adopt a dog?
Any restrictions on breed, size or anything else? If yes, please explain restrictions.
Name of Veterinarian
Phone
(###)
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If you don't have a vet, indicate reason.
Are your pets (current or previous) spayed/neutered?
If no, please provide reason why this has not been done.
Are your pets (current or previous) up to date on their vaccinations?
If no, please provide reason why this has not been done.
Personal Reference 1: Name and Relationship (May NOT be family member, parent, child, spouse or partner.)
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Phone
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(###)
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Personal Reference 2: Name and Relationship (May NOT be family member, parent, child, spouse or partner.)
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Phone
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(###)
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Have you ever owned a dog?
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Do you have any pets now?
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If not included above, list type of pet(s), name & age. If pet is dog, list approximate weight. How many years has each pet lived with you? If not deceased, where is the pet now?
Please reference this scale to indicate what activity or energy level you would like your dog to have. What level would fit in best with your lifestyle? Do you prefer a laid back companion or a higher energy partner?
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What does a normal day look like for each pet? How much time do you spend together? What sorts of things do you do? If you do not have pets, tell us what you would plan to do if you adopted one of our dogs.
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On an average day, how many hours will a dog be alone without a person to spend time with?
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Do you expect this to change within a year of adopting a dog? If yes, what will the new number of hours alone be?
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Where will the dog be when alone? You can select more than one response.
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If other, please explain:
Are dogs allowed on the furniture in your home?
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If the dog is only allowed on some furniture, how do you plan to teach the dog what is allowed or not allowed?
Where will the dog sleep at night?
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Will you enroll this pup in positive reinforcement dog training classes to help him get started?
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If the answer is "No", please explain.
Where will you bring your pup for training or which trainer will you work with? Have you contacted them to ask about current classes?
Socialization is a very important part of a dog's life. How do you plan to socialize your dog?
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If you are exploring other options for adoption, where are you in the process?
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How did you learn about VT Dog Rescue?
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If other, friend or family member - please let us know who we can thank for the referral.
Life is full of change, in what situation would you want to give up your dog?
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Additional Comments: Please use this space to clarify any answers or share additional information. Thank you!
By submitting this application, you certify all of the information in this application is accurate and subject to verification. You agree to keep the dog as an indoor house pet - not a dog who spends unsupervised time outside. You agree to maintain regular veterinary care including annual vaccines and monthly heartworm prevention for this dog.
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