adoptrescuedogs.comShelter adoption Forms

Welcome to AdoptRescueDogs.com

Please read and answer the following questions carefully. Also, following the application is a copy of the contract which you will be required to sign at the time of the adoption. This is a legally binding agreement, so please be sure that you fully understand both our adoption policy, the Texas statute requiring animal sterilization, and that you are prepared to comply with all adoption requirements. Thank you very much.

Before completing the adoption application, you may want to read the free book, Adopting a Rescue Dog. It is very informative, and gives very useful information about the best way for you, your family, and your new pet to adjust to each other and to build a long, healthy, loving relationship.

This free book guides you through the first seven days of Adopting a Rescue Dog. With seven simple lessons, the book helps you ease the transition from shelter life to home life for you and your pup. You can download your copy here.

Dog Adoption & Foster Care Application

Mailing Address:
PO Box 898
PointBlank Tx 77364
Phone: (Ranch) 936-377-4049 (Cell) 281-229-8830
www.adoptrescuedogs.com

Please fill out this application completely, including N/A in any blank field that is not applicable to you, and click submit at the bottom of the document. Once submitted we will start the review process, which usually only takes a day or two. Upon acceptance of your application, we will promptly contact you to make further arrangements. It is our desire to place an animal with you that will be as compatible as possible. In this way, we can help to assure that both you and your new pet will have a forever relationship. Thank you for helping us to make this possible. Please feel free to contact us concerning any questions you may have.

Name of animal(s) you wish to adopt/foster:

Applicant Name:

Co-applicant Name:

Street Address (not PO Box):

City, State Zip:

If less than 2 years, previous street address:

City, State, Zip:

Will you allow a representative of the rescue organization to visit your home?:
If you answer no, your application may be rejected.

E-mail Address:

Home Phone with Area Code:

Work Phone with Area Code::

Cell Phone:

I am age 21 or older ( ID required):

Applicant Occupation::

Applicant Employer::

How Long?

Co-applicant Occupation::

Co-applicant Employer:

How Long?:

Who will be mainly responsible for this pet?

Where will pet be kept during the day?

If other, give details:

Where will pet be kept in the evening?

If other, give details:

Where will pet sleep at night?

If your pet will be spending time outdoors, do you have adequate shelter for it?

What type of shelter do you have?

Do you have a fenced area for your pet?:

If yes, how large is area and how high is fence?:

Proper preventative medications are necessary for the pet's health. What will you use for heartworm prevention?:

What will you use for flea and tick control?:

Do you own or rent?

If you rent, Landlord's name:

Landlord's phone:
Please be aware that it may be necessary for us to contact your landlord to verify his/her knowledge of this adoption application and to check on deposit requirements.

Residence type:

How many members in household?

How many are children?

Ages?

Have you or anyone in the household ever been accused and/or convicted of an animal-related crime?

Do you have any other pets?

Are they spayed/neutered?

If not, why not?

Please list name, type, breed, age, and sex of current pets:

Have you had pets in the past?

If yes, please list types and what happened to them:

Name of veterinarian:

Location:

Phone with area code:

Whose name is used as owner of pet on vet records?

Will you use this vet for your new pet?

If not, whom will you use?:

May we contact your veterinarian?

Pets often live longer than 15 years. Are you prepared to take responsibility for this pet for its entire lifetime?

It may take your pet a month or longer to adjust to a new home. Are you willing to allow this much time for adjustment?:

It may take your new pet and your current pet(s)a few weeks or more to adjust to each other. A new pet will upset the established pecking order and until a new one is formed, there may be some growling, even a fight or two. Are you willing to allow your pets time to adjust to each other?

Do you agree to return the pet to the rescue organization in the event that you can no longer keep it?

Have you ever adopted from a humane organization in the past?

If yes, name of shelter or organization:

Have you ever relinquished an animal to any other shelter?

If yes, please explain::

Please provide the name, phone number and E-mail of a pet friendly reference (neighbors, friends, co-workers etc.) One relative may be used as a reference.
(Reference #1)

Please provide the name, phone number and E-mail of a pet friendly reference (neighbors, friends, co-workers etc.) One relative may be used as a reference.
(Reference #2)

Agreement:

By electronically signing and submitting this application, I agree that the information provided is true, and agree that any misrepresentation of information may result in losing adoption privileges. I further agree to investigation of all statements on this form, and understand that veterinarians, landlords, other humane organizations, references, etc. may be contacted. I also understand and agree that the adoption of the animal may be delayed until this information can be verified, and a representative of the rescue organization may do a home visit. If at any time a representative of the rescue organization and/or local authorities determines that the animal is being neglected or abused, this application and any subsequent contract will be null and void, and ownership of the animal will revert back to the rescue organization. Signed:

Today's Date:

Dog Adoption and Sterilization Contract

PO Box 898
Pointblank Tx 77364

Beth or Bill Smith: 936-377-4049 or 281-229-8830

Please read carefully as you are contractually agreeing to follow these guidelines regarding the adoption of your pet from our organization. Please read and initial each item.

Please Print:

Adopter's Name: ______________________________________ Fee Paid:_____________________
Animal(s) Name:______________________________________ Cash or Check #________________
Rescue Representative:_________________________________

I hereby agree to:

1.___ Keep and maintain the animal in a humane manner, and keep it in my home or on my fenced property.

2. ___ Take the animal to a licensed veterinarian within 10 days from the adoption date for a
medical examination, to insure its health.

3.___ If not spayed or neutered at the time of adoption, have the animal spayed or neutered by a licensed veterinarian by _______/______/20_______. In the event that I do not have the animal spayed or neutered within the specified time frame, the ownership of the animal shall revert back to the rescue organization.
STERILIZATION OF THE ANIMAL IS REQUIRED UNDER CHAPTER 828 OF THE TEXAS HEALTH AND SAFETY CODE. A VIOLATION OF THIS CODE IS A PUNISHABLE CLASS C MISDEMEANOR.

4.___ Provide any medical attention required or needed. This includes at least one (1) annual medical check up, any vaccinations indicated and preventative medications (e.g. heartworm preventative).

5.___ Have the animal vaccinated against rabies as required by state law. We routinely vaccinate against rabies at the time of spaying or neutering.

6.___ Not give away or abandon the animal. If I find myself unable to keep and care for the animal, I will return it to the rescue organization.

7.___ Hold the rescue organization harmless from any incurred fees or damages caused by the animal while in my care.

8.___Hold the rescue organization harmless if the pet has an illness that went undiscovered while in its care, as I understand that a veterinarian has treated this pet during this time, and that they have taken every step possible to provide me with a healthy animal.

9.___ Give permission to agents of the rescue organization to visit my premises at any reasonable time to insure compliance with this contract.

Fees paid at the time of adoption include:

1. First and possibly additional follow-up veterinarian examination(s) up to the time of adoption.
2. All age appropriate vaccinations up to the time of adoption.
3. Any medications, including preventative, that the pet has been on up to the time of adoption.
4. Care and feeding of the animal while at the rescue organization or its foster facilities prior to adoption.
5. Micro-chipping for identification purposes.
6. Spay or neuter surgery completed prior to adoption, or refund of $50.00 if the procedure is done by your own veterinarian after the adoption date. Verification of surgery must be submitted before fees are released.

Signature of Adopter:___________________________________________ Date:______________________

Street address of Adopter:____________________________________________________________________________

Mailing address if different than above:____________________________________________________

E-mail address of adopter:_______________________________Phone:__________________________

Name of animal(s) you wish to adopt/foster:
Applicant Name:
Co-applicant Name:
Street Address (not PO Box):
City, State Zip:
If less than 2 years, previous street address:
City, State, Zip:
Will you allow a representative of the rescue organization to visit your home?: If you answer no, your application may be rejected.
E-mail Address:
Home Phone with Area Code:
Work Phone with Area Code::
Cell Phone:
I am age 21 or older ( ID required):
Applicant Occupation::
Applicant Employer::
How Long?
Co-applicant Occupation::
Co-applicant Employer:
How Long?:
Who will be mainly responsible for this pet?
Where will pet be kept during the day?
If other, give details:
Where will pet be kept in the evening?
If other, give details:
Where will pet sleep at night?
If your pet will be spending time outdoors, do you have adequate shelter for it?
What type of shelter do you have?
Do you have a fenced area for your pet?:
If yes, how large is area and how high is fence?:
Proper preventative medications are necessary for the pet's health. What will you use for heartworm prevention?:
What will you use for flea and tick control?:
Do you own or rent?
If you rent, Landlord's name:
Landlord's phone: Please be aware that it may be necessary for us to contact your landlord to verify his/her knowledge of this adoption application and to check on deposit requirements.
Residence type:
How many members in household?
How many are children?
Ages?
Have you or anyone in the household ever been accused and/or convicted of an animal-related crime?
Do you have any other pets?
Are they spayed/neutered?
If not, why not?
Please list name, type, breed, age, and sex of current pets:
Have you had pets in the past?
If yes, please list types and what happened to them:
Name of veterinarian:
Location:
Phone with area code:
Whose name is used as owner of pet on vet records?
Will you use this vet for your new pet?
If not, whom will you use?:
May we contact your veterinarian?
Pets often live longer than 15 years. Are you prepared to take responsibility for this pet for its entire lifetime?
It may take your pet a month or longer to adjust to a new home. Are you willing to allow this much time for adjustment?:
It may take your new pet and your current pet(s)a few weeks or more to adjust to each other. A new pet will upset the established pecking order and until a new one is formed, there may be some growling, even a fight or two. Are you willing to allow your pets time to adjust to each other?
Do you agree to return the pet to the rescue organization in the event that you can no longer keep it?
Have you ever adopted from a humane organization in the past?
If yes, name of shelter or organization:
Have you ever relinquished an animal to any other shelter?
If yes, please explain::
Please provide the name, phone number and E-mail of a pet friendly reference (neighbors, friends, co-workers etc.) One relative may be used as a reference. (*Reference #1*)
Please provide the name, phone number and E-mail of a pet friendly reference (neighbors, friends, co-workers etc.) One relative may be used as a reference. (*Reference #2*)
Agreement: By electronically signing and submitting this application, I agree that the information provided is true, and agree that any misrepresentation of information may result in losing adoption privileges. I further agree to investigation of all statements on this form, and understand that veterinarians, landlords, other humane organizations, references, etc. may be contacted. I also understand and agree that the adoption of the animal may be delayed until this information can be verified, and a representative of the rescue organization may do a home visit. If at any time a representative of the rescue organization and/or local authorities determines that the animal is being neglected or abused, this application and any subsequent contract will be null and void, and ownership of the animal will revert back to the rescue organization.	Signed:
Today's Date:

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