Adoption Application

Transcription

1 PO Box 431 Helotes, Texas, Adoption Application Please complete in full and in as much detail as possible. Completion of this application does not guarantee approval to adopt a dog from (GaDaH). PRINT CLEARLY SO WRITING IS ELEGIBLE. Main Applicants FULL Name: Address: City: State / Zip Code: Home / Cell Phone: Address: How did you find out about? Does anyone in the household have any known allergies to animals? If there is more than one person involved with your home situation, have you thoroughly discussed what this adoption will entail in the terms of time, energy, financial expenses (e/g. routine/emergency medical care, food, supplies, boarding, etc.) effort and affections? Have you and your family considered that a dog lives for years? Have you carefully considered how the dog will fit into your lifestyle? If you have children how are you going to teach them the proper way to handle and treat a live animal? Are you willing to accept that the dog might not like all your children s friends? Have you checked for dangerous articles, plants or anything that could cause harm to your dog? Are you willing to accept to the commitment? Is everyone in agreement? Do you intend to keep the dog primarily indoors or outdoors? Please elaborate: 1

2 1. Is there currently a specific dog you are interested in, if so provide details below? Yes No Dog's Name: Breed: Age: Sex: Why this dog in particular? 2. Do you have any preference to the sex of your new dog? Male Female Either 3. Do you have any preference as to the color of your new dog? 4. What is the main age you would like to adopt? Puppy (under 6 months) Young Adult (6 months 3 years) Adult (3 years 6 years) Senior (7 years and up) Any Age 5. What characteristics do you expect in your new dog? Active Playful Independent Protective Dominant Shy/Docile Calm Loving Aggressive Submissive Good with other pets Good with children Other (please explain): 6. Do you intend on training or using your dog as any type of working dog? Yes No Police K9 Search & Rescue Service Dog for Disabled Other 7. Do you intend on attending any kind of obedience, rally or agility classes with your dog? 8. Current Residence, do you: Own a single home Rent a single home Own a condo/town house Rent/lease a condo/town house/apartment Brief description of property: If the property is rented a letter from the landlord stating you are permitted to have a dog of this breed. 2

3 9. Will you be moving or relocating in the near future? Yes No If yes, are you able to take the dog with you, guaranteed? Yes No 10. Do you have a minimum 6ft fenced in yard where you reside for exercising and playing with your dog? Yes No What type of fencing? Is it 100% secure with no gaps, loose, or damaged parts? Yes No 11. If you have a pool, is it fenced? If not what precautions will you take to ensure your dog is safe? 12. Are there any distractions outside your yard that could plague the dog? (i.e., neighbors dogs, loose dogs on the street, mischievous children)? 13. How do you intend to provide the dog suitable exercise for its needs (age, breed, weight, energy level)? 14. Approximately, how many hours each day do you anticipate your new dog will be home alone? 3 hours or less More than 3 hours More than 6 hours More than 8 hours More than 12 hours 15. Where and how would you keep your dog when left alone? 16. If the dog will be alone for 6 hours or longer, what provisions will be made for the dog to relieve its self and get exercise during our absence? 17. Where will your dog sleep at night? 18. Do you have any intention of using your dog for guarding or protective purposes? Yes No Please describe: 19. How many adults live in your home? How many children live in your home? Children s ages & sex. 3

4 20. What other pets do you currently have? 21. Are all pets licensed within the legal requirements of the City and State of Texas? Yes No 22. Are you familiar, or have you researched breed characteristics, common medical conditions and other needs the dog will require? Please explain: 23. Are you financially capable to provide for your dog, (hip displacia, arthritis, cancer) should any emergency arise? Yes No 24. Would you be able to rely upon family/friends, financially should an emergency occur that you are not able to cover? Yes No 25. Have you ever given away/euthanized/or surrendered to a shelter any pet due to financial situation? 26. Have you owned a Dog of this breed before? Yes No 27. Reason you no longer have him/her? 28. Please provide a brief history on the dog/s 29. If you currently own a dog your dog/s on monthly heartworm prevention medication? Yes No If no, reason why not: 30. Are ALL your pets up to date on their vaccinations as recommended by your veterinarian? Yes No If no, reason why not: 4

5 31. Please provide any other information that will help GaDaH process your application. Veterinarian Information: Current: Previous Practice Name: Doctor s Name: Full Phone Number: Street Address: City: State, Zip Code: How long at practice: Registered pets: If you do not have a current vet, GaDaH highly recommends Callaghan Road Animal Hospital they care for all of the GaDaH animals. Occupation Information: Main Applicant: Co-applicant (Spouse/Partner) Job Title: Company Name: Supervisors Name: Length of employment: Employers Address: City, State, Zip Code: Full Phone Number: I state that all information is true and correct to the best of my ability Signature: Date: Print Name Signature 5

6 Before anyone can be approved for adoption, a home-check will need to be conducted, by a GaDaH Board Director; the following paperwork submitted, (must be originals and have a recent date); and phone checks made. Two letters of personal references, along with address s and phone numbers, with area code. This does not include family members. A letter from your current veterinarian (or previous if you do not have one) stating that you take proper care of your pets. A Letter from the landlord (if applicable) stating, you are allowed a dog of this breed in the property. 6