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RED HOOK DOG RESCUE
Harriet Zucker
Brooklyn, NY 11231
harithspi@gmail.com
alexdecampi@gmail.com
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Adoption Application
Name of Dog I'm Interested in Adopting
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Your answer
Your Name
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Your answer
Address
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Your answer
City, State, Zip
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Your answer
Email address
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Your answer
Home & Work Phone #
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Your answer
Are you over 22? (you must be 21 or over to be considered)
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Yes
No
Other:
Required
Please list all those living in your home (name, relation, age, phone # if adult)
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Your answer
Do all of the adults living in your home know that you are planning to adopt?
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Choose
Yes
No
Places of employment and phone numbers
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Your answer
Work Schedules
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Your answer
Do you live in:
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A house in the country
A single family home
Co-op or Condo
Apartment
Other:
Required
Do you
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Own
Rent
If you rent, does your lease allow pets?
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Choose
Yes
No
Landlord's name, address and phone #:
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Your answer
Are any dog breeds restricted in your town or city?
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Your answer
Are you planning on moving within the next year?
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Choose
Yes
No
If you are moving, where and when?
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Your answer
Does anyone have any known allergies to pets?
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Your answer
If yes, to what and how severe?
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Your answer
Do any members of your household fear animals? If yes, please explain
Your answer
Do you have any pets now?
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Yes
No
Required
If so, please list all breeds, genders & ages.
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Your answer
If this will be your second dog, what is motivating you to bring a another dog into your family?
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Your answer
Have you owned dogs in the last 5 years?
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Yes
No
Required
If yes, what breeds have you owned?
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Your answer
Please explain why you no longer have this dog (s)?
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Your answer
Have any of your pets ever gotten lost?
Yes
No
Other:
Have any of your pets ever been poisoned?
Yes
No
Have any of your pets ever been hit by a car?
Yes
No
Have you ever given a pet to a shelter?
Your answer
If you had to move or relocate, what would you do with your pet?
Your answer
If you are living with a partner & the two of you separate, where would the pet go?
Your answer
If you are unable to care for your pet in any way, who will take care of your pet?
Your answer
If you have dogs now, are they spayed or neutered?
Yes
No
Other:
Are they up to date on inoculations?
Yes
No
Other:
Are they heartworm tested?
Yes
No
Other:
If yes, when were they last tested?
Your answer
Are they on heartworm preventative medication?
Choose
Yes
No
What is your veterinarian's name, address & phone #?
Your answer
Do you have a yard? If yes, what is the size?
Your answer
Is your yard fenced?
Yes
No
Other:
If not, are you planning to do so?
Your answer
Are you planning to exercise the dog?
Your answer
Do you have a dog crate?
Yes
No
Other:
How long would the dog go crated daily, if at all?
Your answer
Do you have an outside kennel?
Your answer
Do you have an outside doghouse or shelter?
Your answer
Do you belong to any kennels or training clubs? If so, which ones?
Your answer
Would you adopt a dog with treatable health conditions?
Your answer
Would you consider a special needs dog? (daily meds, deaf, etc.)
Your answer
Would you adopt a dog with a disability? (amputee, heart condition, etc.)
Your answer
Who will be responsible for the care of this pet?
Your answer
Where will the pet be kept during the day?
Your answer
At night?
Your answer
Who will care for your pet during vacations?
Your answer
Will the dog be left alone without human companionship?
Your answer
How long?
Your answer
Where will it be kept when alone?
Your answer
What will you do if your dog is destructive while alone?
Your answer
What is your definition of disciplining a dog?
Your answer
Are you now or have you been in the past a breeder? Please explain.
Your answer
Please list 3 references
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Please include: Name, Address, and Phone # (no more than one relative) & (it would be great if one were a neighbor).
Your answer
How long have you been looking for a dog?
Your answer
Why do you want to bring a pet into your home?
Your answer
What kind of dog are you looking for?
Do you have any preferences? ( doesn’t go on furniture, good with kids, good with cats, other dogs, etc..)
Your answer
Do you want this dog for:
(check all that apply):
House pet
Guard dog
Companion
Gift
Companion for another pet
Hunting
Obediance/agility
Therapy
Other:
IF the dog you are planning to adopt is a pit bull or pit bull type dog:
Are you familiar with the characteristics and temperament of these dogs?
Your answer
Why do you want to adopt a dog of this breed?
American Staffordshire Terrier, American Pit Bull Terrier, etc..)
Your answer
As you know, pitbulls have gotten a bad rap lately. We feel that they are very special dogs and a great pit is worth its weight in gold. As a responsible owner, part of your job is to be their PR person and an educator. Please go to
www.badrap.org
and read as much as possible. Thanks!
No problem, will do!
Do you plan to take your dog to obedience classes?
(Highly recommended, in fact, we insist. Training has changed so much in the last 10 yrs. Classes done early-on pretty much guarantee a polite, well mannered dog later on. They are for both the dog and it's human(s)! Also they are fun. :)
Yes
No
Other:
Are you financially able to care for a new pet?
(feeding, routine vet care, vaccinations, parasite checks, emergency vet. care, licensing, etc..)
Yes
No
Other:
Adopted pets need an adjustment period. Are you willing to give the new dog at least one month trial to ensure proper adjustment?
Yes
No
Other:
Are you willing to take responsibility for this dog for the rest of its life?
Can you make a commitment for the many years that this dog could live? (10-18 yrs)
Yes
No
Other:
By checking this box, you are agreeing that all of the information you have provided above is True & Accurate, and that you wish for Red Hook Dog Rescue to evaluate your application for the adoption of the dog you have specified.
After evaluating your form, if you are being considered for adoption, Red Hook Dog Rescue will contact you to schedule a home visit.
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