SECOND CHANCE ANIMAL RESCUE WINDSOR-ESSEX ANIMAL ADOPTION APPLICATION DOG Second Chance Animal Rescue Windsor-Essex (SCAR) reserves the right to discard applications that have not been completed in full. Only qualified applicants will be contacted. All potential adopters will be subject to home visit screening and reference checks as part of the adoption process. The application should be completed by the expected primary caregiver of the animal. Please answer in detail where possible. Allow for at least 72 hours for a response. DOG S NAME (1 ST CHOICE): DOG S NAME (2 ND CHOICE): DOG(S) I AM INTERESTED IN I CONFIRM THAT I HAVE READ THIS DOG S BIO AT SCARESCUE.ORG AND CONFIRM THAT I FULFILL THE LISTED HOME REQUIREMENTS, EX. FULLY FENCED YARD, ANOTHER DOG IN THE HOME, ETC. How did you hear about our rescue? Ex. Facebook, PetFinder, friend, etc.: Are you working with another rescue or shelter to adopt a dog? NAME: ADDRESS: If yes, please name: APPLICANT INFORMATION CITY: PROVINCE: POSTAL CODE: AGE: EMAIL: EMPLOYER: CELL TEL: OTHER TEL: WORK TEL: FACEBOOK ID: INSTAGRAM ID: TWITTER ID: NAME: SPOUSE INFORMATION (IF APPLICABLE) AGE: EMAIL: EMPLOYER: CELL TEL: OTHER TEL: WORK TEL: FACEBOOK ID: INSTAGRAM ID: TWITTER ID: Are there children living in your home? HOME AND FAMILY INFORMATION If yes, list names & ages of all children: Do children visit your home? (ex. grandkids) Are there others living in your home? If yes, how often and list ages of all children: If yes, list names, ages, & relationship: Does anyone living in your home have asthma or allergies to animals? If yes, explain the details How would you describe yourself (check all that apply): What is your personal activity level? Page 1 of 7
Are you a student? If yes, do you change residence between terms? Ex. Go home for summer, holidays, etc. Are you expecting a child or planning a family? Does your or your spouse s job require frequent out-of-town travel? Are you or your spouse subject to relocation? If yes, when? If yes, how often? If yes, when and/or how often? Does anyone in your home smoke? Do you rent or own your home? If yes, check all that apply: If rent, provide landlord name and telephone: Have you lived at your current address less than 2 years? If yes, provide previous address: Type of dwelling you live in: Does your home have a pool? If yes, please describe (ex. Above ground, fenced,et.): Does your home have a fully fenced yard? If no, please explain (ex. Partially fenced, no yard, etc): Please specify height if less than 6 and/or material if not wood or chain-link: If your home has a fenced yard, what type? Does your yard have access from a street? If yes, please explain (ex. No gate, locked gate, etc.): Are you planning to move in the near future? If yes, when and where (ex. 2 months, to London, etc.): If you move, will your pet go with you? Page 2 of 7
Do you currently have any animals in your home? Type/Breed Age Sex ANIMAL CAREGIVING HISTORY Vaccinations up-to-date? Heartworm Protective? Spayed/ Neutered Indoor/Outdoor Pet? Have you owned animals in the past? If you have euthanized an animal, please explain the circumstance (ex. Old age, incurable illness, etc.) Type/Breed Age Sex Spayed/ Neutered Explain why you no longer have this pet? Have you ever surrendered or rehomed an animal in your care? If yes, please explain the circumstances: What is your current animal s temperament with dogs? Page 3 of 7
If your current animal does not like dogs, please explain your strategies for overcoming this: How would you deal with a dog that doesn t listen to you? If your dog growled at you over food or a toy, how would you react and respond? ANIMAL PLACEMENT INFORMATION What role would you like your dog to play in your life? (check all that apply) Where do you want this dog to live? What type of activity level are you looking for in a dog? What types of activities would you enjoy doing with your dog? (check all that apply) What fur length/type are looking for in a dog? What circumstances might justify giving up a dog? (check all that apply) If your dog exhibits behavioural or adjustment issues, would you be willing to seek advice from a SCAR representative? Are you willing to pay for behavioural or obedience sessions? Where will the animal stay when you are at home? Where will the animal stay when you are not at home? (ex. Work, vacation, etc.) Page 4 of 7
How many hours per day (on average) will the animal be alone? Do you plan to use a crate? Why or why not? What kind of solution would you be willing to try if housebreaking accidents occur? What food do you plan to feed the animal? If known, which brand? What type/style of collar do you intend to use? Are you willing to bring the animal to yearly vet exams & vaccinations per your vet s recommendations? Vet Care (regular visits): Approximately how much do you expect to spend on your animal per year? Vet Care (emergency visits): Grooming: Food: Boarding: A dog can live 10+ years, why do you feel you can make this commitment at this time? A rescue dog can take time to adjust to a new, loving home. What are your strategies for easing their transition to your home? How long do you think it will take a rescue animal to adjust to a new environment (your home) and how long are you willing to provide them to adjust? What behaviours are unacceptable in a rescue dog AND what would cause you to return them to us? Page 5 of 7
In your own words, what makes you a responsible pet guardian? Under what circumstances would you consider euthanasia for an animal? Would you allow a SCAR representative to visit your home after adoption for an update on the animal s physical condition and happiness? ANSWER THIS SECTION FOR ANIMALS UNDER 1 YEAR OF AGE AT TIME OF APPLICATION Puppies take time and patience to raise. Do you feel that you have the time and patience to commit to a puppy? Have you ever crate-trained a puppy? How long would you leave a puppy in a crate per day? What is your plan of care for a puppy if you will be away from home for more than 3 hours? What is your plan to exercise a puppy daily? If a puppy displays destructive behaviours (ex. Chewing shoes, etc.), what is your plan of action for responding to these behaviours? Puppies can eat things or have injuries in their first year that require emergency trips to the vet. Are you prepared for this additional extra cost? Page 6 of 7
REFERENCES References must be non-relatives and must have known you a minimum of 5 years. For vet references, use current vet and/or any vets seen within the last 5 years. You must contact your vet(s) to let them know that a SCAR representative has your permission to query your file to determine care history of animals. PERSONAL REFERENCE #1 NAME: PHONE: PERSONAL REFERENCE #2 NAME: PHONE: PERSONAL REFERENCE #3 NAME: PHONE: VET REFERENCE #1 NAME: PHONE: VET REFERENCE #2 NAME: PHONE: By signing below, I confirm that I have answered all questions truthfully knowing that any intentional false statements will void this application. I understand that submitting an application does not guarantee approval and that Second Chance Animal Rescue Windsor-Essex reserves the right to approve or deny any application based on policies, procedures, and needs of each animal. I authorize representatives of SCAR to contact my vet(s) to confirm animal care history, such as vaccination records, and to investigate any statement made on this application. All puppies under 1 year of age will be considered foster to adopt until their first birthday and will remain under ownership of Second Chance Animal Rescue Windsor-Essex until they are spayed/neutered and should wear SCAR identifying tags at all times. The adopter(s) is responsible for all medical and other costs once the animal is placed in their home. SCAR will pay for the animal s spay/neuter after the foster-to-adopt contract has been signed. Signature of applicant: Print: Date: Signature of co-applicant: Print: Date: When application is completed in full, then signed & dated, please scan and email to scar.adoptions@hotmail.com or drop off completed form at one of our adoption events. Application Comments: Click or tap here to enter text. Application is: Signature of SCAR Representative: SCAR REPRESENTATIVE SECTION ONLY Print: Date: Page 7 of 7