New Hope Dog Rescue Adoption Application

Your Name:

If any, list the breed(s) that interest you

List specific dog(s) that interest you

Home Phone

Work Phone :

E-Mail Address:

Street:

City:

Province:

Postal Code:

Occupation:

Daily Work Hours:

Hobbies:

Names and Age of All Household Members:

Who in your household will be the primary care giver?

Residence Type:

Length of Residency:

Do you Rent or Own

Does Landlord Permit Dogs?

Landlord's Name:

Landlord's Phone:

Approximate Size of your Yard:

Is the yard completely fenced?

	Yes
	No

If yes, what type of fencing and how high?

If you have no fence, how will you deal with the dogs toilet and exercise needs?

List type, age, and gender of all household pets?

Are they Spayed/Neutered?

	Yes
	No

If no, please explain:

Describe how you think your pets will react to a new dog:

Have your pets been vaccinated in the last 3 years?

	Yes
	No

Where will the dog spend the day?

Where will the dog spend the night?

How many hours on average will you have to spend with the dog daily?

How many hours will the dog spend alone each day?

What activities will this dog have to do on a daily basis?

What are your plans for the dog? (Agility, Flyball, Obedience, Hunting, Guard work, Search & Rescue, etc)

Have you ever taken an obedience class?

	Yes
	No

Are you prepared for shedding, hair, nose prints, and paw tracks throughout your home?

	Yes
	No

Will you be able to groom the dog?

	Yes
	No

Describe your idea of a great dog:

What will happen to the dog when you go on vacation?

What are your reasons for applying to adopt a dog?

Do you have any concerns?

Have you adopted companion animals from shelters or rescue groups before?

	Yes
	No

How many dogs have you owned in the last five years?

What has happened to these dogs? (Still with you, deceased, etc)

If you have pets, who is your veterinarian?

If you have not had a pet recently, have you chosen a veterinarian for this dog?

Do you agree to license and give regular health care to the dog?

	Yes
	No

Do you agree to contact New Hope Dog Rescue if you can no longer care for or keep the dog?

	Yes
	No

Are you willing to pay the adoption fee for this dog as determined by New Hope Dog Rescue?

	Yes
	No

Adoption fees:

$160.00 for adults.
$160.00 for puppies plus a $100.00 deposit, returned upon submission of spay/neuter certificate.
$75.00 for seniors.

Adoption fees cover the cost of the care for this dog and his/her spay or neuter.

By clicking submit, I am stating that the above questions, to the best of my knowledge, are answered honestly and accurately.