Nebraska No Kill Canine Rescue : Adopt or Foster : Adopt : Adoption Application

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Nebraska No Kill Canine Rescue Adoption Application

This is your chance to give us an idea of what kind of dog you’re really looking for. The providing of false information herein will result in the forfeiture of any adoption.

Where did you first learn about our rescue?

Which dog are you interested in?

Where did you first learn about the dog you are applying to adopt?

Applicant Name

First Name

Last Name

Applicant Age (Required)

Email Address (Required)

Street Address

Country

Address Line 1

City

State

Postal Code

Home Phone

Cell Phone

Full name of all adults in the home, their relationship to applicant and age:

Full Name

First Name

Last Name

Relationship

Age

Full Name

First Name

Last Name

Relationship

Age

Full Name

First Name

Last Name

Relationship

Age

Are there any children living in or regularly visiting the home:

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If yes, how old are the children?

Occupation

Length of Employment

Current Employer

Work Phone

Current Veterinarian

Clinic/Veterinary Hospital

Phone Number

Past/Additional Veterinarian

Clinic/Veterinary Hospital

Phone Number

List any Humane Socieites, Organizations, Breed or Training Clubs you're associated with:

Do you live in a house, apartment, condo/town home or mobile home?

House
Apartment
Condo/Town Home
Mobile Home

Do you rent or own your home?

Rent
Own

If you rent:

Landlord name

Phone #

Address

Do you have landlord's approval to have pets?

Any size or breed restrictions?

Are there any ordinances that limit the breed of dog you can own or the number of pets you can have?

How long have you been at your current address?

Do you have any plans to relocate?

Where will the dog stay when you travel for work or vacation?

Is your yard securely fenced for a dog? No holes or gaps to escape through?

If you have a fence, what type and how tall is it?

How and how often will the new dog be exercised?

Is there anyone in your home with pet allergies?

Please list breed, age and sex (M, F, MN=male neutered, FS=female spayed) of all pets in your household?

Are there other animals on the property (cows, horses, chickens, etc.)?

How many dogs have you owned in the past?

What happened to them?

Have you successfully trained a dog in any basic commands (sit, stay, down, come, etc.)?

If no, do you plan on training this dog?

How (professional training classes, reference books, etc.)?

How will you/do you prevent heartworm disease?

Have you used flea prevention?

What kind?

Where will the dog stay while you are away from the house (working, shopping, etc.)?

How many consecutive hours will the dog be confined to inside?

If you don't have a crate, would you be willing to purchase one if the new dog needs to be crated?

Do you have any experience at crate training a dog?

Where will the new dog sleep?

What type of house-training methods will you use?

What do you consider a realistic cost to properly care for a dog for one year?

Have you ever had to re-home one of your pets?

If yes, please explain?

Describe the kinds of personal situations where you might have to return your adopted dog.

If you move, will you take the dog with you?

At what point would you consider humane-killing (euthanasia) should your dog become ill?

Have you ever tried to adopt from another humane society, rescue or shelter in the past?

If yes, which group?

If denied, which group and why?

Would you allow us to visit your home prior to adoption?

Are all adults in your household aware and agreeable to adopting this dog?

Are any of your current or previous pets outdoor dogs?

If yes, please explain?

What activities do you plan on doing with your new dog?

What form of identification will be used to ensure your pet will be returned to you if he/she is lost?

Do you think a dog should be allowed or trusted off-leash in an unfenced area? Explain:

Pets require time to acclimate to their new home. How much time are you willing to give this pet?

Do you expect any major life changes within the next 10 years-marriage, children, relocation, ect.?

What is your primary reason for wanting to adopt this dog?

What is important when choosing a dog food? Choose your top 3

Price
Nutritional Content
Age Appropriate for Dog
Organic
Appearance
Brand
Grain-Free
Kibble Size
Other

What dog food do you intend to feed your dog?

What do you think are the most important responsibilities in owning a dog?

Please provide names, phone numbers, and best time to contact them for two unrelated references:

Name

First Name

Last Name

Phone #

Contact time(s)

Name

First Name

Last Name

Phone #

Contact time(s)

By signing below, you are in agreement and compliance to our application process and agree that all information on this application is true.

Signature

Date

Falsification of any of the above information will be grounds for disallowing the adoption of a rescue animal and possible removal of said animal from the home.