Animal Shelter Adoption Application Form

Your Name (First & Last):*

Street Address:*

City, State, Zip*

Phone Number:*

Area CodePhone Number

Alternate Phone:

Area CodePhone Number

E-mail:

Employer:*

Employer reference & phone number:*

How do you prefer to be contacted?*

PhoneTextEmail

Please provide the name of the pet you are interested in, or "No Preference"*

Please list all current pets in the household: (Breed, age, spayed/neutered)*

Please list previous pets from the last 5 years & where they are now:*

Are you considering adopting more pets in the future?*

YesNo

Choose which best describes your level of dog owning experience:*

Advanced (Dog behavior & training background)Intermediate (Always owned dogs)First Time (Never had a dog)Not applying for a dog

What qualities are you looking for in a companion?*

Are you concerned with any of the following behaviors?*

Which of these behaviors are you willing to work through, with training & support from The ARRC?*

What activities would you like to do with your new pet?*

Briefly describe your average day:*

Are there any specific preferences or personality traits you are looking for?*

What kind of food do you plan on feeding your new pet?*

Would you consider adopting a pet with existing medical needs, that are currently being treated?*

YesNoMaybe

If The ARRC is unable to board your animal, who will care for the animal during times you are away?*

What do you plan to do with the animal if you move? What if there are restrictions pertaining to your pet?*

Who will inherit the animal in the event of a death? (Please list two references with phone numbers)*

Do you consent to a brief home visit, prior to finalizing the adoption of your new pet?*

YesNo

Are all members of your household in agreement with this adoption?*

YesNoI Don't Know

Who will be the pet's primary caregiver?*

Do you live in a*

HouseApartmentCondoOther

Do you own or rent?*

OwnRent

If renting, please provide name and contact number for landlord/property management:*

Does your landlord/property management/HOA allow dogs at your residence?*

YesNo

Are there any restrictions from your landlord/property management/HOA?*

Number of petsSize or weight restrictionsBreed restrictionsNone

Size of your backyard:*

Do you have a fully fenced yard?*

YesNo

Height & type of fence: (N/A if not applicable or no fence)*

Where will the pet be kept when you are not home?*

Does your yard include a pool?*

YesNo

How many adults are in your household?*

How many children are in your household?*

Please list children's ages:(N/A if no children)*

Have children in the home been around animals, before?*

YesNo

Does anyone in your home have asthma or pet related allergies?*

YesNo

Household Activity Level:

Please list 2 personal references with phone numbers: *

Do you currently have pets?*

YesNo

Please list all current pets: (Breed & Age included) (N/A if no pets)*

Are your pets up to date on vaccines & preventatives? If not, briefly explain why:*

How many of these pets are spayed/neutered?*

Have you adopted from a rescue group or shelter, previously?*

YesNo

If yes, which rescue/shelter?*

Have you ever had to surrender an animal?*

YesNo

If yes, please briefly explain the circumstances?

Please list any pets you have owned in the last five years & where they are now: (N/A if not applicable):*

Which of the following would you like more information on?*

Do you have a vet you use, currently?*

YesNoI would like help finding one

If so, please provide the name, address, & phone number of your vet:

Briefly explain why you are interested in adopting? (N/A for Fosters)*

Preferred activity level:*

High Energy/Jogging buddyModerate ActivityLow ActivityCouch Potato

Do you plan on crate training your new pet?*

YesNo

Have you ever potty-trained an animal before?*

YesNo

How do you plan on exercising your new pet & how many days per week?*

How many hours each day will your new pet be home alone?*

Where will your pet stay when your are not home?*

Where will your new pet sleep at night?*

How do you plan on helping your new pet best adjust to their new home?*

What will you do if bad habits form?*

Are you willing to utilize The ARRC's support & training tools, if any behaviors of concern arise?*

YesNo

Under what circumstances would you have to give up your pet?*

How hear about The ARRC?*

I agree that the information I have provided is true
I understand that applying does not guaruntee adoption
I understand that a meet & greet with a dog does not guaruntee adoption

I understand that The ARRC spends a minimum of $250 in vetting costs per intake, & adoption fees are donations towards care & medical needs to continue to help each rescue dog who takes the place of an adopted one.

Please allow The ARRC team 2-3 business days to process your application. You will be contacted by phone or email, provided.

Thank You for considering an ARRC pup!

The Animal Rehab & Rescue Center Adoption Application

Applicant Information:

About Applicant:

Household Information:

Current/Previous Pet Information:

Adoption Information: