ADOPTION APPLICATION – CHEW Dog Rescue

Applicant Name *

First

Last

Co-Applicant Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Applicant Email *

Co-Applicant Email

Evening Phone

Cell Phone

Employer

Co-Applicant's Employer

How did you hear about CHEW Dog Rescue?

Number and age of household members (please include all)

Adults:

Minor Children:

Adult Ages:

Minor Children Ages:

Are you expecting a child or planning a family in the near future?

Are all your family members in favor of a rescue dog?

If no, please explain

Is anyone in your household allergic to dogs?

If yes, please explain

Type of dwelling you live in

Do you own or rent?

Own
Rent

Do you have landlord’s permission to keep a dog? (Renters Only)

Dog size limitations? (Renters Only)

Landlord Name

First

Last

Landlord Phone

How long have you lived at your current address?

Do you plan to move in the near future?

Would you be willing to allow us to conduct a home-safety inspection via video?

INFORMATION ABOUT THE KIND OF DOG YOU WOULD LIKE TO ADOPT

Name of the specific CHEW Dog Rescue dog(s) you are interested in, if applicable

ARCHIE
MARNIE
MASON (Adoption Pending)

Type of dog preferences, if any (size age range, gender, etc.)

Why do you want to adopt a rescue dog; share your reasons:

DOG ENVIRONMENTAL INFORMATION

Is part of your yard fully fenced?

What is the approximate size of the fully fenced yard?

Height & type of fence

Do you have a pool?

If yes, is it securely fenced?

How many consecutive hours a day are you away from home for work, school, etc?

Do you plan to keep the dog primarily indoors or out? Please explain:

Where will your dog sleep? If in the house, where in the house?

How do you plan to exercise the dog(s)?

What other activities do you plan to do with the dog?

Where will your dog stay when you go on vacation?

Do you plan to take your new adopted dog to obedience class?

If no, please explain:

Who will be the primary caregiver for this dog?

Please describe your training method, including your approach to eliminating undesired behavior.

Please let us know what makes you an ideal candidate to adopt a rescue dog:

Please share your plan to care for your dog if you become physically unable or predecease it.

PETS, PAST AND PRESENT-

LIST ALL DOGS YOU CURRENTLY OWN

Breed

Age

Male/Female

Spayed/Neutered?

Spayed
Neutered

Indoors or Outdoors

Indoors
Outdoors

Breed

Age

Male/Female

Spayed/Neutered?

Spayed
Neutered

Indoors or Outdoors

Indoors
Outdoors

Breed

Age

Male/Female

Spayed/Neutered?

Spayed
Neutered

Indoors or Outdoors

Indoors
Outdoors

LIST ALL CATS YOU CURRENTLY OWN

Breed

Age

Male/Female

Spayed/Neutered?

Spayed
Neutered

Indoors or Outdoors

Indoors
Outdoors

Declawed?

Breed

Age

Male/Female

Spayed/Neutered?

Spayed
Neutered

Indoors or Outdoors

Indoors
Outdoors

Declawed?

Breed

Age

Male/Female

Spayed/Neutered?

Spayed
Neutered

Indoors or Outdoors

Indoors
Outdoors

Declawed?

Other pets you currently own, please list:

Describe the breed(s) and size(s) of any previously owned dogs:

If you’ve had dogs in the past, where are they now?

Have you ever given a dog up or had a dog for a brief period of time and it didn’t work out?

If yes, please explain the circumstances

How would you provide for your dog’s medical bills if they become expensive?

REFERENCES
List three references that can attest to your suitability as a pet owner and, more specifically, the owner of a rescue dog. Only one reference can be a family member. References will be contacted once the adoption process begins.

Reference 1 *

First

Last

Reference Phone

Reference Relationship

Reference Email

Reference 2 *

First

Last

Reference Phone

Reference Relationship

Reference Email

Reference 3 *

First

Last

Reference Phone

Reference Relationship

Reference Email

I am over 18 years of age and information I have given above is true and complete.

Print Name

a or Male/Female

Signature

Clear Signature

Date

I would like to receive future emails from CHEW about education seminars, dog-related events, fund-raising activities and other useful information pertaining to dog care. I can unsubscribe at any time by clicking on the link at the bottom of the email.

Information you submit on this form is kept confidential and used only for the purpose of considering your interest in adopting a CHEW Dog Rescue dog.

NOTE: We are an all-volunteer rescue who are always looking for the perfect home for each of our dogs. YOU WILL ONLY HEAR FROM US, TYPICALLY WITHIN 72 HOURS IF YOU ARE DETERMINED A GOOD MATCH FOR ONE OF OUR RESCUES. Not all applications or inquiries may receive a response. Only completed applications will be reviewed before a possible meet and greet is arranged.