Rescue K9-1-1: Adoption Application

For you to be considered for adoption of one of our precious little ones we ask that you please complete the following application as honestly and accurately as possible. (Once completed please be sure and press the 'Send Application ' button at the end of the application so that we receive your application. Thank you so much!!! Please do not hesitate to contact us should you have any questions.

* indicates required field

* Your Name:
* Email address:

Home Street address:
City:
State:
Zip:
Drivers Lic. No.:
Phone No.:

What type of dog are you looking for?:

What size?:

Do you prefer male or female?:
Male
Female
Not Important

Is this dog for you?:
Yes
No

If no, please explain:

Will it be inside, or outside?:
Inside
Outside

What role would a dog fill in your household?:

(Companion, guard, hunting, or member of the family)

Please list the names and ages of members of your household:

Who will be primarily responsible for the care of the dog?:

Where will the dog live during the day and/or night?:

Will the dog have run of the house, be blocked off from parts of the house, use a crate, or live in the yard?:

Please list other pets, ages and if they are spayed/neutered:

Have you ever bred dogs?:
Yes
No

Do you plan to?:
Yes
No

Is your residence a house/condo/apartment?:

Do you rent or own your residence?:

If you rent, what is the pet policy?:

Do you have a yard?:

Is it fenced? What type of fence and how high?:

Will the dog be chained at any time?:
Yes
No

If yes, please explain:

Is someone home during the day?:
Yes
No

If not, how long will the dog be alone (average)?:

Have you had dogs in the past?:
Yes
No

What happened to them?:

Are you familiar with the costs of veterinary care?:

Who is your vet?:

What is his address?:

What is his phone number?:

Please provide a personal reference.
Reference name:

Reference address:

Reference phone number:

Would you allow Rescue K911 to come for a home visit?:
Yes
No

Please add any additional comments you have below:

***I understand that this is an application for adoption and that Rescue K911 reserves the right to approve or decline this application based on the needs and personality of this particular dog. I also understand that some dogs have special needs and those that may require the need of a secure fenced in yard, and this may become a consideration of a particular adoption and application. Though it costs us anywhere from $250.00 - $500.00+++ for each rescue we operate solely on donations and from the kindness of those that love animals. All of our little ones are spayed/neutered before adoption. We would kindly ask for a minimum adoption donation ($85.00 dogs & $75.00 cats please) which helps so much towards the next rescue..."Thank you"!!!!

**** (Please be sure and press 'Send Application' button once completed...thank you)

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