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Rescue K911 > Adoption Process > Adoption Application

Online Application

For you to be considered for adoption of one of our rescued dogs we ask that you complete the following application as honestly and accurately as possible. This information is requested so that we can assist you in the selection of a new dog. This form and consultations with an adoption representative are designed to help you find the dog most compatible with your lifestyle.

In order to be considered as an adopter you must:

  • Be 21 years of age or older (or with parental consent)
  • Have identification showing your present address
  • Have the knowledge and consent of your landlord.
  • Be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet.

Thank you so much. Please do not hesitate to contact us should you have any questions.
* indicates required field

* First Name :
* Last Name :
* Home Street address :
City :
State :
Zip :
Home Phone :
Cell Phone :
* Email :
Age :
How long at this address :
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)
Describe a typical day with your & your new dog :
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? :
What is your activity level? :
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)? :
If your new dog/puppy is not housetrained, what method will you use to train it? :
If you go away for a few days, or on vacations, who will take care of the dog? :
If you move, will you take the dog with you? : Yes No
Explain :
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 :
How did you hear about Rescue K911? :
Would you allow Rescue K911 to come for a home visit? : Yes No
Are you willing to take the responsibility for this dog for the next 10 to fifteen years? : Yes No
Please add any additional comments you have below :
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***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-$500.00+ for each rescue we operate solely on donations and from the kindness of those that love animals. All of our dogs are spayed/neutered before adoption. We would kindly ask for a minimum adoption donation ($85.00) which helps so much towards the next rescue…Thank you!!!

Please be sure and press ‘Send Application’ button once completed.

At times we do experience difficulty-receiving applications via email…if you have not received a response from us within 24 hours of your application, please contact us at 256-896-4694, or email rescuek911inc@yahoo.com

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