Canine Castaways, Inc. |
1. Do you presently own any pets? If YES, please list the name and kind for each pet. |
2. Have you owned pets in the past? If YES, what kind and what happened to them? |
3.a. If you own dog(s) are they all spayed/neutered? If NO, why not? |
4. Where do you live? |
5. Does your home have a yard with a fence? |
6. Do you own or rent your home? |
If you RENT, do you have permission from your landlord to keep a dog? |
7.a. Do you have a crate to keep the dog in? |
8. What is the longest period of time that the dog would be left unattended? |
7.b. Where will the dog sleep? |
10. Where will you keep the dog while you are at work or out on errands? |
11. Where will you keep the dog while you are on vacation? |
12. What dog are you interested in adopting and why this breed or particular dog? |
13. Do you have a preference for sex, color or age bracket? If so, what is it? Please note that this is used as a guide only- there is no guarantee we can find you a dog of your preference. |
14. How many adults presently in the house? |
Women? |
Men? |
15. Are there children presently living in the house? If YES, what are their ages? |
16. Do you agree to a Canine Castaways representative visiting your home to inspect prior to and/or after adoption? |
17. Are you willing to enroll the dog in obedience class or other training if you experience behavior problems? |
18. Do you understand that the dog should never should never be allowed off lead in open places? |
19. Please provide us with a veterinary reference. (including phone number) |
20. Please provide us with a personal reference, not related to you. (including phone number) |
21. All of our dogs are spayed/neutered, vet-checked, up to date with shots and evaluated before they are placed. Our adoptin donation of $175 helps with these expenses. Do you understand the need for these donations and the fact that all donations are NON-REFUNDABLE after 7 calendar days? |
26. Your additional comments: |
ADOPTION APPLICATION |
NAME: |
ADDRESS: |
CITY, STATE ZIP CODE: |
HOME PHONE: |
WORK PHONE: |
EMAIL ADDRESS: |
DOG OR DOGS YOU ARE INTERESTED IN: |
All applicants are subject to a home visit. We reserve the right to refuse or reject any application for whatever reason we deem fit. |
Type of Fence: |
Height: |
If NO, how will the dog get excersie and relieve itself? |
22. Have you ever owned a rescued animal? |
ALL APPLICANTS ARE SUBJECT TO A HOME VISIT. WE RESERVE THE RIGHT TO REFUSE OR REJECT ANY APPLICATION. IT MAY TAKE SEVERAL DAYS FOR YOUR APPLICATION TO BE REVIEWED, DEPENDING ON THE VOLUME OF APPLICATIONS RECEIVED. PLEASE BE PATIENT. YOU WILL BE CONTACTED AS SOON AS POSSIBLE. |
ALTERNATE EMAIL ADDRESS: |
PLEASE NOTE: We must have an email address for all applicants. |
23. Do you understand all of the expenses involved with caring for a dog, especially as it ages? Including but not limited to ordinary and emergency veterinary expenses, heartworm preventative, dental care, grooming, etc. |
Age range of Applicant: |
24. Have you applied with another rescue organization in your search for your new family member? It helps us to realize this when trying to coordinate our volunteer efforts. |
25. Do you understand that there are no guarantees about the house training, behaviors, temperament or health of a dog that is adopted and that the adjustment period varies for each dog? |
"A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL FREE (1-800-435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE." SOLICIATION REGISTRATION NUMBER CH16703 |
YEARS AT CURRENT RESIDENCE: |
3.b. If you own dog(s) are they on heartworm preventative? If NO, why not? |
Please provide your landlord's name and telephone number. |
7.c. Will the dog be allowed on furniture? |
9. Does anyone in the household suffer from allergies or asthma? |
Please provide the name of any other group you have applied with. |