Application for Canine Guardianship
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Applicant's General Information
Full Name of Applicant*
Occupation:*
E-mail*
example@example.com
Address*
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code Country
Phone Number*
Co-Applicant (Spouse, significant other, roommate):
Personal Email:
Occupation/Employer
Please list all pets in your household. Include both current AND past.*
Species & Breed Age Gender Spay/ Neuter? Temperament Residing with you?

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For any pet no longer residing with you, please tell us why the pet is no longer in your home:*
Please list all the people in your household. NOTE: SDR DOES NOT PLACE DOGS IN HOMES WITH CHILDREN UNDER AGE 6. IN ADDITION, SDR DOES NOT TYPICALLY ADOPT TO APPLICANTS UNDER AGE 26.*
Name Age
Self
Person #2
Person #3
Person #4
Person #5
Is everyone in the household on board with adopting a new dog? Please note each person’s level of commitment to the new dog using the following 1-to-5 scale: 0 indicates “don’t want a new dog in the house,” 1 indicates “I will be ok with having a new dog in the house but do not intend to be responsible for his/her care”; 5 indicates “I am excited about adding a new dog to the home and look forward to being responsible for his happiness, training, and wellbeing.”
1 2 3 4

5

Self
Person #2
Person #3
Person #4
Person #5
Do you have your heart set on one specific SDR dog? If so, who is that? It helps us to know whether you are only applying for a particular dog or are flexible in your options.

Your Environment
Please describe your residence & environment:
Urban, suburban, or rural?*
Do you own or rent? Is this house, condo or apartment?*
If rent, include property owner's name, phone number, address, and email.
How long have you resided at this location?*
Do you have a fenced yard? (answer YES or NO).*
If you do have a fence, please describe: height, material, approximate size of enclosure:
Does anyone in the home smoke cigarettes or marijuana? (answer YES or NO).*
Do you have any health concerns or condition that affects the kind of dog that would be a good fit, or may do so in the future? If yes, please describe (i.e. asthma, allergies, lyme disease, arthritis)*
Please describe your typical weekly schedule, including *how many hours your dog will typically be alone, and *for how long, and *where will your dog be when left alone? :*
Doggie Wishlist
The following questions are to help us get an idea of what dog would be a good fit for you. There are no right or wrong answers, so please be as honest and accurate as possible.
Why do you want a dog?
Will your dog be allowed on the furniture? Please rate on a scale of 1 to 10 your rules and expectations about the couch and/or bed. 1 indicates “ I do not want a dog to be on the furniture and will take great measures to make sure it is not on the furniture, including training and management”; 5 indicates “I would prefer my dog NOT be on the couch, but if the dog is accustomed to being on furniture, or likes furniture I will make accommodations (i.e. cover couches, buy a second hand couch etc.)” ; 7 indicates “I don’t care either way” ; 10 indicates “ I prefer to adopt a dog that likes furniture”.
Are you planning on a dog walker or daycare? If you are planning on using daycare or dog walking service please let us know who:
What kind of vehicle(s) will your dog be transported in? Would you use a secured crate or consider a seatbelt for your dog’s safety?
Describe how your dog be exercised daily i.e. a few blocks during the week, playing fetch in your yard, daily hiking on trails on leash, hiking off leash, long walks in neighborhood park, weekend hikes:
What daily activities are important for you to have your dog partake in i.e. dog park, hiking, good with other dogs, going to brewpubs, waiting in car while you run errands (when not hot), going to barbeques at friend's homes with other dogs/kids, joining family gatherings?
If you need to relocate, how will your dog fit into that plan?
Do you regularly have children or other guests visit your home? How often do children visit specifically? Will your dog be exposed to children on a regular basis (in parks, playground, home settings).
If you are in a relationship and you and your significant separate, what would happen to your pets?
Do you foresee any major life changes over the next two years? (e.g., promotion/transfer at work, military deployment, relationship change such as marriage, remodeling your home or yard, having children)
What physical and personality characteristics are you looking for in a dog (e.g., low-shedding, male/female, energy level, a training project or more of a stable dog with lots of history)? (the more info we have here, the better)
Summit Dog Rescue rescues dogs of indeterminate origin from shelters, individuals, and organizations throughout the United States. While many of our dogs look like purebred or nearly purebred, and we guess as to what breeds they may be, we do not make any guarantees as to their breeding or that their temperament will resemble that of the breed they look most like.

Questions Regarding Vet Care

What do/would you spend on the following categories of medical care?*

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Routine care (please provide the dollar amount you think is reasonable for annual non-emergency care)
Emergency medical (e.g., up to $1,000; up to $5,000; over $5,000)
Other/additional comments about medical care

What do you consider to be part of those expenses?*
Are you aware of health concerns related to over-vaccination in pets? Please answer YES or NO*
You can read more about this topic here; https://www.whole-dog-journal.com/health/beware-of-over-vaccinating-your-dog/
Have you ever had a dog with a medical emergency (i.e., torn ACL or bloat) or a long term illness (i.e. cancer)? Please explain: how did you treat the condition; what was the cost; what was the outcome?
In the case of a treatable medical issue (example: bloat $5,000 surgery), what do you consider reasonable and manageable in terms of medical treatment, cost, quality of life, etc?
With the skyrocketing costs of veterinary care, have you or would you consider pet insurance? Please answer YES or NO.*
SDR dogs come with a certificate for one free month of insurance with Trupanion pet insurance.
What brand of dog food will you feed your dog? Why this brand?*
We highly recommend researching dog foods and their ingredients at www.dogfoodanalysis.com and www.dogfoodadvisor.com.

Training & Behavior
NOTE: If in our process, you realize that you have used a training technique that used force, fear or pain - don’t feel bad. The past decade has seen a huge scientific breakthrough in our understanding of canine behavior and training. Almost all of us used these outdated methods, because that was what we were taught. We strive to help applicants learn about teaching your dog in a modern, positive/force free environment that fosters learning and trust.
Have you ever had a dog with behavior problems? If so what behavior(s) and how did you work with your dog on this issue?

Please read the following article and then answer the questions based on the information in the article. https://www.psychologytoday.com/blog/canine-corner/201205/is-punishment-effective-way-change-the-behavior-dogs*

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Do you watch any dog trainers on television? If so, who?
Does a dog misbehave in order to display dominance over it’s human?
Is it important to “alpha roll” your dog as part of effective training?
According to the article, what kind of training tends to increase aggression in dogs?
Describe one thing you learned from the article.

If you are approved to adopt from Summit Dog Rescue, you will be required to be signed up for a class or private lessons with a positive reinforcement/force-free trainer in order to receive your new dog. We will verify this with the trainer. What trainer do you plan to use? Feel free to refer to our website for additional information. www.summitdogrescue.org/training.html*
Adopted dogs experience an adjustment period of at least several months. What do you expect that to involve and you are fully committed to adjusting your life to help your new dog learn to feel safe?*
Please refer to our website and read more about adjustment periods for newly-adopted rescue dogs.
Behavior
The first few months upon adopting tend to be the most difficult. Your new dog has been through many transitions, and your home is just one more transition in his mind. New behaviors can crop up, or previously seen behaviors can be amplified during the transition period. Working through these issues can be challenging and time consuming, and so please be as clear and honest as possible so we can help you get as close to the right fit as possible. Please note that dogs have the emotional capacity of a 3-4 year old child.
Please identify behaviors you would NOT be willing to work with:*
(e.g., growling at strangers, Lunging on leash at other dogs, nipping children, separation anxiety, leash pulling, housetraining accidents, counter surfing, other)
Many dogs thrive with a guardian who will carry a treat pouch with high value food rewards when out on walks (or when seeing new stimuli). Would you want a dog that requires (for success) that each walk entails dispensing a cup or two of food rewards? Or would you RATHER adopt a dog who DOES NOT require that much regular, consistent need for food rewards and training? :*
How important is it to you to modify any behavioral challenges the dog may have? Please give a number between 1 and 10 based on the following criteria: 1 is “I will find time to work with my dog twice a week for 5 to 10 minutes”; 10 is “I will make significant changes in my own behavior in order to help modify my dog’s(s) behavior.” Each adult who is involved with the dog(s) should answer this question.*
Training Commitment
Self
Person #2
Person #3
Person #4

Person #5
Please consider the following scenarios. Please indicate if you would consider returning the dog. What action would you take if a week after adopting your new, mild-mannered dog, he began barking and attempting to nip at unfamiliar person who entered your home?*
What steps would you take if upon adopting a dog that was represented as housebroken, your new dog began marking your furniture? Would you return the dog?*
What would you do if your new dog shows signs of separation anxiety? Such signs can include destructiveness, barking, whining, chewing, and scratching at doors. Would you consider returning? What would you do?*
Please list the TOP THREE most important behaviors that you would like to see reasonably quickly in your newly adopted dog (i.e. friendly with kids, good with cats, easy to walk on leash, housetrained, okay alone in the house, crate trained, quiet, food-motivated, okay with loud noises etc):*
If this dog will be an addition to an existing dog(s): Would you expect them to get along right away? Would separating them with babygates in your home be something you would do to try and help them develop a positive relationship? How long would you consider to be reasonable to ease in a new dog (i.e. days, weeks, months?) Please answer in detail below:*
What would you do if after several weeks at home with you, your newly adopted dog started barking at strangers whenever you took him for walks?*
Under what circumstances would you consider returning your adopted dog? Please think through this answer carefully i.e. nipped a jogger, bit my child, attacked my cat, bit my mother in law but did not require medical visit, bit the UPS man etc:*
What is your training budget? Please understand, if approved to adopt, you must purchase classes or privates from a trainer on our SDR approved trainer list (or we will find you one in your area) and show proof of purchase, before your adoption contract is drafted. Here is a link to our pre-screened trainers: http://www.summitdogrescue.org/training-and-sdr-approved-trainers.html*
$
Basic manners (total amount)
Behavioral issues (total amount) ($0; up to $250; over $1,000)

	Training Commitment
Self
Person #2
Person #3
Person #4
Person #5

	$
Basic manners (total amount)
Behavioral issues (total amount) ($0; up to $250; over $1,000)

Almost Done!
Have you ever lived with a dog from a rescue organization or shelter?*
Are you pre-approved or currently applying with other rescues? (This does not hinder your approval with SDR, but could help us process your application more efficiently, as many rescues work in collaboration with each other.) If yes, please say who you are applying with.*
What is your timeframe for adopting?*
Ready and eager for a dog this week; actively looking at shelters and surfing the internet Applying with multiple rescues; hoping for the right match in the next few weeks Happy to wait a few months for the right fit I am only applying for one specific dog, and if I don't get him/her I will look no further
Each Summit Dog is adopted out with a Freedom Harness. SDR dogs are on heartworm prevention and you will receive several pills months of pills upon adoption.
Do you agree to contact Summit Dog Rescue if after adoption you are unable to continue to be a guardian for your adopted dog, and either return your dog to us or work with us to find another suitable home for your dog? Please answer YES or NO.*
Do you agree to pay the $485 adoption donation? (Unless a dog is stated as “sponsored” , that is our standard adoption fee – a few “sponsored” dogs are a lower fee adoption fee, because an angel donor sponsored a portion of their fee). Please answer YES or NO.*
Do you agree to read to the short book "Love Has No Age Limit: Adopting an Adult Dog Into Your Home" by Patricia McConnell PhD. BEFORE your home visit is conducted?*
Yes No Maybe
Please give a veterinary reference if you have one. A past reference is fine. Name, address, phone number please! Thank you.*
Please list three personal references (not a relative or household member), whom you have known for at least three years, who can vouch for your character as a pet guardian. Give name, address, phone, and email:
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Reference #1; Name and Relationship, Address, Phone, Email*
Reference #2; Name and Relationship, Address, Phone, Email*
Reference #3; Name and Relationship, Address, Phone, Email*
The full Summit Dog adoption process includes a phone interview, a personal reference check, and a home visit and then a meet and greet! Submission of this application confirms that you understand and agree to the need for screening of adopters, and certify that the information supplied on this application is true and correct. The terms “guardian” and “owner” shall be considered interchangeable. Please initial here that all your responses are truthful and complete.*
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	Species & Breed	Age	Gender	Spay/ Neuter?	Temperament	Residing with you?
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Application for Canine Guardianship

Doggie Wishlist

Behavior

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