Spot On Adoption Center Adoption Application

Are you applying to adopt a specific dog? If so, who?

If you are not applying to adopt a specific dog, what kind of dog are you looking for? Color? Age? Breed? Other?

When are you looking adopt? (Please mark only once) *

As soon as possible
1-2 months from now
Other

If Other, please explain.

If “as soon as possible,” are you prepared with all of the necessary supplies so if you meet the right dog, you can bring him/her home immediately? Necessary supplies may include a dog bed, food/water bowls, dog food, crate (if necessary), etc. *

Yes
No

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

What is your current employment status? *

Employed
Unemployed
Self-Employed
Student

Job Description and Place of work:

Do you live in: *

A house
An apartment

Do you: *

Own
Rent

If you rent, do you have consent from your landlord to have a dog?

Do you have a fully fenced yard?

Yes
No

What type of fence do you have?

If “Other,” please explain.

Are there restrictions with your community on the numbers of pets you can own?

PLEASE NOTE: It is definitely worth checking with your county! Local ordinances may set limits as to a certain number of pets per home.

How many people live in your home? How many adults? How many children? If children live in the home, what are their ages?

If no children live in your home, are children frequent visitors to your home? If so, please specify their ages:

Does anyone have any known allergies to dogs?

Does anyone inside the home smoke?

Yes (Outdoors Only)
Yes (Indoors and Outdoors)
No

Do you have any pets now? How many? What kind?

How long have you had these pets? Give number of years individually:

If above you mentioned that you have dogs as pets, please provide their age and type of breed:

Are your pets spayed or neutered?

Yes
No

Are your pets on Heartworm preventative?

Yes
No

If you do not own pets currently, have you owned pets previously?

If so, what kind? Please also provide the information requested above regarding these pets. What happened to these pets? *

Have you ever given a pet away? If so, to whom and for what reason? *

What do you consider a justifiable reason for giving a pet away? *

Would you adopt a dog who is known to have bitten in the past? *

Yes
No
Maybe

Please note that it is our policy to disclose any known bites and any known circumstances of any known bites.

If a dog who is placed in your care should bite after going home, what measures will you take? For example, would such an incident prompt you to return the dog immediately? To consult a behaviorist? To take the dog in for a medical check? *

Would you adopt a dog with treatable health conditions? *

Yes
No
Maybe, it depends

Would you consider a special needs dog? (Daily meds, deaf, etc.) *

Yes
No
Maybe, it depends

Would you adopt a dog with disability? *

Yes
No
Maybe, it depends

Who will be responsible for the care of this pet?

Where will the pet be kept during the day? During the night?

If you work outside the home, what arrangements will you be making to have the dog walked during your work day?

Please provide a name and telephone number as a veterinary reference. If you have never owned a pet, please provide a personal reference's name and EMAIL ADDRESS instead. Many vets will not speak to us without your permission. Please make sure you call your vet to let them know that we will be calling and grant them authorization to speak with us. PLEASE NOTE: Applications without either a vet or personal reference will NOT be considered.

Have you ever submitted an application to another rescue that was refused? If so, what reasons were given?

Are you financially able to take care of this pet (food, grooming, veterinary bills, dog walking, etc.)?

Yes
No

Having answered all these questions, do you agree to take care of the dog placed with you in good and bad times, in sickness or in health, until death do you part?

Yes
No

Would you like to be added to our email list to receive news, information on adoptable dogs, and info on events, etc.?

Yes
No

During the adoption process, you will have the opportunity to meet our dogs. In connection with these meetings, you agree as follows: " I recognize and acknowledge that there are certain risks of injury or loss in interacting with animals. " I agree to assume the full risk of any injury or loss, including, but not limited to, personal injury, property damage, or death, which I may sustain related to any adoption activities associated with Garden Rescues. " I do hereby fully release and discharge Garden Rescues, its officers, agents, directors, and employees (the "Garden Rescues Parties") from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney's fees, (collectively, "Claims") which may accrue to me on account of my volunteering with Garden Rescues, including but not limited to any and all Claims caused in whole or in part by the negligence or other fault of the Garden Rescues Parties. " I further agree to indemnify and hold harmless the Garden Rescues Parties from any and all Claims arising out of, connected with, or in any way associated with my involvement with Garden Rescues. " I understand that in connection with the adoption, my photo may be taken. I hereby grant Garden Rescues permission to use my likeness in photograph(s) and/or video(s) in any and all of its publications or online, whether now known or hereafter existing, without notice or compensation to me. *

I have read and understand.

Garden Rescues can, at their discretion, choose to conduct a home visit during the application process. I understand that if my application is accepted a representative of Garden Rescues can conduct a home visit in order to determine if the pet is a good fit. *

I have read and understand.

I agree that all the information contained in this application is true and correct. I also agree that have read and understood the foregoing and agree to the terms and conditions herein. I understand that if my application is accepted, I will be required to enter into an adoption contract prior to adopting my dog. Garden Rescues shall have the right to remove any dog placed with an applicant should it discover that the applicant has made any material representations. *

I have read and understand.

Digital Signature *

Date