Benji’s Buddies Animal Rescue
Adoption Application for Dogs
Name ______
Address ______
Email address ______
Phone Home ______Alternate ______
Which dog are you interested in? ______
What makes you want to adopt at this time? ______
Does anyone in your household have allergies to dogs or cats? ______
List anyone else who shares your residence, their age and relationship to you. ______
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Are family members in agreement about getting a dog? ______
Is this a family pet or just for the kids?______
If primary reason is for children, what happens when they are old enough to move out? ______
Other pets in household? List type, age, size and temperament: ______
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Are they fixed? ______If not, why not?______
Do you live in a
( )single family home, ( )apartment, ( ) condo, ( ) other – please specify ______Do you (own) or (rent)? (circle one)
If you rent, we require written documentation that you are approved to have a pet, the weight restrictions (if any) and breed restrictions. Please attach a copy of your lease to this document. Please provide the name and number of your landlord for us to verify pet policy.
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Do you have a fenced backyard? ______If so, what size is it? ______
Is the gate to your backyard padlocked? If not, how is it secured? ______
What is the surface below the gate, i.e. gravel, cement, grass, dirt?______
How tall is the fence? ______Material fence is made of ______
Do you have a pool? ______Is the area fenced? ______
If not, how will you address the safety of this dog?______
Do you have prior experience owning a dog? ______Describe: ______
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Have you ever had to surrender a pet? _____ Why? ______
Have you ever lost your pet? _____Circumstances?______
How many hours, on average, will the dog spend alone each day?______
Will you and are you able to provide healthcare for the dog, including emergency vet bills, which can often be costly? ______
Are you financially able to provide food, supplies, etc. also? ______
Will you obtain obedience training if necessary to address any behavior issues that may develop? ______
Where would the dog sleep? ______
Would the dog have access to indoors as well as outdoors? (doggie door) ______
How do you anticipate your pet spending its days? ______
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Do you agree to contact Benji’s Buddies Animal Rescue with any problems with the dog? ______Do you understand we want the dog returned to us should anything ever arise where you can’t keep it?____
Would you treat this dog as a loving family member for the rest of its life, whether you move, change jobs, lose a job, or anything else?____
Please list your current veterinarian. ______
Please list two personal references/numbers. ______
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THE COMPLETION OF THIS APPLICATION DOES NOT GUARANTEE ADOPTION
Benji’s Buddies Animal Rescue representatives shall use their judgment in securing the best match for this animal. Please be aware that there may be other applications pending for the pet you are interested in. Pet guardianship is a lifetime commitment and we want to place every pet in the home that is most suitable to their needs and background. We thank you for your interest in providing this dog with a good home!
Signature ______Date ______