Rudy's Rescue Adoption Application

Congratulations for wanting to adopt a pet in need. This is our application, not a contract to adopt. This is the first step in the process. A successful adoption depends on finding the perfect pet for you the perfect permanent home for the pet. So please be as complete and honest as possible. We apologize the application is long, but it is necessary to get as much information as possible to make the right match.

Please read our Adoption Info Page for more information about our policies, adoption, and foster-to-adopt plans.

NOTE: We require a $25 deposit donation upon applying. You can pay via Paypal using Visa or Mastercard.

PLEASE NOTE:

(1) WE RESERVE THE RIGHT TO PERFORM A HOME INSPECTION PRIOR TO ADOPTION

(2) WE RESERVE THE RIGHT TO APPROVE OR DENY ANY ADOPTION FOR ANY REASON AND THE RIGHT TO NOT DISCLOSE THE REASON

(3) YOU MUST BE AT LEAST 21 TO APPLY


(4) THE APPLICATION IS GOOD FOR 1 YEAR FROM THE APPROVAL DATE

Do you understand and agree? yes no

 

CONTACT INFORMATION

When answer choices are offered, please check all that apply. Please be as specific as you can.

If you apply for a dog and are outside of our area - you can feel good knowing your application fee will be considered a donation and will be used to help the dogs in foster care with Rudy's Rescue. If you are not sure, please send an email to shimiah@rudysrescue.info to check on your location.

I understand and agree yes no

 

 
Name:
City, State, Zip:
Home Phone:
Work Phone:
Address:
County:
Cell Phone:
E-mail:

 

DOG AND ADOPTION INFORMATION

Name of dog you are interested in
If this dog is no longer available are you willing to consider others of the same breed? yes no

Has anyone in your house ever been convicted of an animal-related charge?
yes no

How soon do you expect to adopt?

What date are you prepared to take a dog home?

How did you find out about us?

Are you applying to adopt from other rescues? yes no
If so, what rescues?

Please understand it takes a great deal of our volunteers' time to process an application. Because of this, a $25 fee will be required with each application. Your $25 fee will be deducted from your final adoption costs.
This fee helps to ensure that you are serious about adoption when applying.

Be advised most applications take two weeks to process. Once you are approved to adopt, you will be contacted via email or phone.

We require a cash, postal money order, or certified/cashier's check donation if approved to adopt.

Do you understand this is non-refundable? yes no

Are you aware of the required adoption fee? yes no

Are you aware of the contractual requirements? yes no

Will you allow volunteers to investigate and/or inquire concerning the dog's circumstances after adoption?
yes no

Do you understand that if all conditions of the adoption contract are not met our volunteers have the right to remove the dog from your home without notice?
yes no

 

 

ABOUT YOUR HOUSEHOLD
How many adults live in the house?
What is the name of the dog's primary care giver?
How many people under age 18 live in the house?
What are the ages of those under 18?
names of other adult residents in the house

If anyone in the house has an occupation that involves animals in any way, what is it?

Are there regular visitors to your home (human or animal)with whom your new dog will interact?

yes no

Does anyone in the house have animal allergies? yes no

If yes, how will you avoid allergic reactions?

Do you own or rent your home?
Own Rent Live with family Other

Do you have a property owners' association? yes no

How long have you lived at this address?
Do you have future plans to move? yes no

If yes, how soon?
What plans do you have for this dog if you move?

If you move where dogs are not allowed, what will you do?

If military, what are your plans for your pet if you are deployed?

Do you have a fully fenced-in yard? yes no

If yes, what is your fence height at its lowest point?

What type of fence do you have?

How big is the fenced area?

If you don't have a fence, how will you handle exercise and potty duties?


If no fence, do you plan to fence in the yard? yes no

If so, when and what type?
Do you have a doghouse? yes no

Do you have a dog crate? yes no

If not, would you be willing to buy one? yes no

Do you have a dog kennel? yes no

REFERENCES

Please list your veterinarian and 3 personal references we may contact.

We prefer they be people who know your experience with animals.

Please notify your references that we will be calling, many references require permission from the applicant to release information.

Vet name
Vet Phone number

Please list three personal references below.
You must include name, relationship, phone, and e-mail.

Reference #1

Reference #2

Reference #3

 

PET OWNERSHIP HISTORY

Labrador Experience

Have you researched the breed(s)? yes no

Have you read books about the breed(s)? yes no

Do you have family members who have owned the breed(s)? yes no

Friends who have owned the breed(s)? yes no

What traits do you like about the breed(s)?

What traits do you dislike about the breed(s)?


Previous Cat Ownership:

Have you owned any cats in the past 5 years you no longer own?
yes no
If yes, please explain:



Previous Dog Ownership:

Have you owned any dogs in the past 5 years you no longer own?
yes no

If no, skip to the next section. If yes, please list description (Include name, breed, sex, age)(Example: Fido, male Lab, age 4)

Prior Dog #1

Prior Dog #2

Prior Dog #3



Current Cat Ownership:

Do you currently own any cats? yes no

If no, skip to the next section. If yes, please list description (Include name, breed, sex, age) (Example: Molly, female DSH, age 4)

Current Cat #1

Current Cat #2

Current Cat #3

Has this cat interacted with medium or larger dogs before? yes no
Does this cat go outdoors? yes no

Current Dog Ownership:

Do you currently own any dogs? yes no

If no, skip to the next section. If yes, please list description (Include name, breed, sex, age) (Example: Fido, male Lab, age 4)

Current Dog #1

Current Dog #2

Current Dog #3

Is this dog indoors when you are gone? yes no

Other Pets:

Are there any other animals the dog will interact with? yes no

How long have you had the other pets?

Pet #1
Pet #2
Pet #3
Are your pets spayed or neutered? yes no

If not, why not?

ABOUT THE DOG YOU WANT TO ADOPT

The questions in this section are designed to help us match the right dog with your family. The more you tell us, the better we can help find you the right dog.


If there is a particular dog that you are interested in, what about this dog sparks your interest?

Are you interested only in that dog? yes no

If yes, skip to "What plans do you have for this dog?" If no, continue.

Must the dog be purebred? yes no
What gender(s) are acceptable to you?
If you have a gender preference, please explain why
Youngest acceptable age?
Oldest acceptable age?
If you have an age preference, please explain why.
What coat colors are acceptable to you?
What plans do you have for this dog?

 

 

How important are the following are to you?

Note: You must select an answer, othewise your responses to these questions will show as "did not select." We need this information in order to help us match you with the right dog for you.

  Unnecessary Trainable Preferred Essential Did not select an answer
Housebroken dog
Crate trained
nondestructive
Good with babies

Good with young children
Good with cats
Good with small dogs
Good with male dogs
Good with female dogs
Will come when called
Won't pull when walked on a leash
Knows basic commands
Won't jump up on people
Won't countersurf
Won't dig
Rides well uncrated in car
Can safely take to dog park
Experienced in use of Doggy Door
Will not protect food and toys
Has no known medical issues

OTHER INFORMATION

How much do you think it will cost you to care for this dog for one year?

Can you afford it? yes no

Rudys Rescue requires a minimum of six weeks obedience training. Are you willing to commit to a minimum of six weeks of obedience training with your adopted dog? yes no

How will you handle submissive urination if your dog develops it after adoption?

There is no perfect dog. Just like humans, dogs make mistakes. For example, a housebroken dog might go back to being not housebroken or the dog may get so attached to you he develops separation anxiety.

 

If the dog you adopt makes mistakes after he comes to your house, what will be your course of action?

How many hours will this dog be alone during the day?

Where will the dog be when you are not at home?

Where will the dog sleep?
Who will care for the dog when you vacation?


Have you ever released a pet to an animal shelter or given away an animal?
yes no

If yes, what were the circumstances?


Have you ever had a dog euthanized for any reason other than old age?
yes no

If yes, what were the circumstances?

Will you keep your dog on heartworm preventative year-round forever?
yes no
Will your dog ride in the back of a pickup truck? yes no

Comments:

Please let us know any other information you wish us to consider in placing a pet with you.



By indicating yes and submitting this form, I signify that all information given in this application is true and correct, to the best of my/our knowledge.
yes no

Do you agree to return the dog you are adopting to this rescue if you cannot keep it?
yes no

 

Rudy's Rescue and Resource Services, Inc. thanks you for taking the time to complete this application. Your interest is deeply appreciated because every dog we can place is one less that is homeless, hungry, abused, or killed. It is our dream for every animal to someday have a home.

Your $25 application fee is a non-refundable donation. If you are approved to adopt, your fee will be applied to your adoption donation. You may choose to pay through Paypal, where you can authorize payment through your Paypal account (if you have one) or through a major credit card.

You will be directed to a page with a PayPal application fee button when you complete this form.


We will start to process your application as soon as your fee is received.

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