Dog Adoption Application - Helping Paws Rescue

*Adoption Application Date:

*Which dog are you applying for?

*Number of adults in the household:

*First and Last Name (Adult 1):

*Gender (Adult 1) this information is collected as some dogs do not respond well to different genders

First and Last Name (Adult 2 if applicable):

Gender (Adult 2) this information is collected as some dogs do not respond well to different genders

*Email

*Address:

*Phone Number (including area code):

Children - age and gender:

*Who will be the primary caregiver?

*Is anyone in the household allergic to animals?

Please list pet allergies if you answered YES above:

*Do you own or rent your home?

*Outside of Ontario - If you rent do you have your landlord’s permission to have a dog?

*How long have you lived at your current address?

If less than 3 years what was your previous address?

*Describe your residence (fenced yard?) if fenced describe fencing. If not fenced, describe how you plan on keeping the dog from escaping?

*How do you plan on meeting your dog's needs for exercise?

*Do you have a dog kennel or run? If yes please describe size etc.

*Where will your dog spend a normal day?

*On average, how many hours a day will your dog be left alone?

*When alone, where will your dog be kept?

*Where will your dog sleep at night?

*Do you plan on using a dog crate?

*Are there currently animals in your home?

If yes please list them, including type (dog, cat, bird, etc.) gender, spayed/neutered, breed, age:

*Please list all the pets you have owned in the past 10 years, other than the one’s you presently have, and what happened to each of them. Please be very specific.

*Have you ever bred or raised dogs?

*Why do you want to adopt this breed of dog?

*When you go on vacation, where would your dog stay while you're away?

*What would you do if you moved somewhere and they don’t allow pets?

How would you handle the following behavioural problems?

*Jumping on furniture:

*Excessive barking:

*Chewing:

*Digging

*House soiling:

*Aggression toward other dogs:

*Aggression toward humans:

*Which of the above would cause you to return the dog to the rescue?

Describe the type of dog you are looking for:

*Size preference:

*Age preference:

*Gender preference:

*Desired level of activity:

Other preferences or traits not mentioned above:

*Would you be willing to adopt a special needs dog? (health problems, behaviour problems, etc.)?

*If the dog you are interested in is no longer available, would you be interested in another one of our dogs?

REFERENCES (Please DO NOT use relatives for your references)

Reference 1 - Your Vet

NOTE: Please call your vet and give them permission to speak to us. They will not give us a reference unless you do.

*Vet Name / Vet Clinic:

*Vet office phone number (including area code):

*Vet address:

Reference 2

*Name:

*Relationship to you:

*Email address:

*Phone Number Ref #2

*Best time to call Ref #2

Morning before 12PM

Afternoon - 12PM - 7PM

After 7PM

Reference 3

*Name:

*Relationship to you:

*Email address:

*Phone Number Ref #3

Best time to call Ref #3

Morning before 12PM

Afternoon - 12PM - 7PM

After 7PM

Please use the area below for any other comments or questions you may have.

Is there anything else you'd like to tell us?