People Loving Pets Rescue Adoption Application

Please fill out this form completely; failure to answer one or more questions may result in your application being rejected. Completion of this application does not guarantee adoption of a dog. Thank you for choosing adoption!

Name of Desired Dog: *

Date: *

Your Name: *

Spouse's Name *

Age: *

Occupation: *

Name/ Ages of Children, if any: *

Your Home Address: *

Line 1

Line 2

City

State

Zip Code

Country

Any other occupants in home: *

Your Phone Number: *

Email Address: *

Type of dwelling: *

House Condo Apartment Other

Do you Rent or Own? *

Rent Own

If renting, do you have your landlord’s permission to have a dog? *

Yes No

Landlord’s name and phone number: *

If you have children, please describe their previous experience with dogs: *

If your children did not want a dog, would you be interested in adoption one for yourself? *

Does anyone in your household have allergies? *

If yes, describe: *

Do you have a pet now? *

Type of Pets (if dog, list breed) *

Other Pets? *

Have you ever allowed an animal to breed? *

How Many? *

Ages: *

Sex(es): *

Are your pet(s) spayed/neutered? *

Is there anybody home during the day? *

When will the dog be inside? *

About how many hours will the dog be left alone? *

Where will the dog sleep at night? *

Who? *

Outside? *

Where will the dog stay when he/she is home alone? *

If other or if you have additional comments on where the dog will sleep, please specify: *

What rooms are off limits to the dog? *

Do you have a doggie door? *

Height of Fence at Highest Point? *

I have recently inspected my fences, and they are in good condition: *

Yes No

I promise to inspect my fences thoroughly before the home visit and make necessary repairs for the safety and well being of our new Pet: *

Yes No

What outside areas are available to the dog? *

Type of fencing? (Chain link, wood, block wall, etc.) *

Height of Fence at Lowest Point? *

The fence is intact on all sides and is at least 6 feet from the ground level in all areas: *

Yes No

Are there gates? *

Yes No

How many gates? *

How high? *

Is there any type of lock on the gate(s)? *

Yes No

Type of lock (padlock, key, latch, etc): *

If no locks, would you be willing to install them prior to placement should this application be accepted? *

Yes No

Preferred level of exercise with dog: *

Couch potato Short walks Vigorous walks Jog regularly

When you go on vacation, who will care for the dog? (friend, kennel, dog sitter, etc.) *

Would your dog wear a collar? *

Yes No

When? *

Would you allow your dog to wear an I.D. Tag? *

Yes No

How would you discipline your dog if he or she misbehaved? *

If Other, Explain: *

How do you normally walk your dog? *

On leash Off leash

When on leash do you normally use? *

Collar only Corrective collar Harness Other

Are you willing to live with hair on the furniture, stains on your rugs, a warm body on your bed, and an animal that might be destructive at times? *

Yes No

Are you able to make a long-term commitment to care for your pet for its entire life span, which could be as much as 10 to 20 years? *

Yes No

Pets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, shelter, and exercise for your new pet? *

Yes No

What would happen to your pets if you moved? *

Comments: *

Please list pets you have owned since you have been an adult and the length of ownership; if they are no longer with you, please provide an explanation: *

How did you find out about our adoption program? *

Why are you interested in adopting from a rescue? *

Please read and check each statement bellow that applies: *

I understand that a home visit is required prior to final placement I understand that a home visit does not guarantee placement I CAN give a non tax deductible gift of at least $250 to help PLP rescue continue to provide medical care, spay, and neuter, board and place other abandoned and neglected dogs into forever homes I understand that any donation or contribution is a gift freely given, not a purchase price for a dog I agree to provide my own collar, leash, harness, and a personal ID tag at the time of completing the adoption contract I understand this questionnaire becomes part of our contract

Please list the name of the dog you’re interested in again, and tell us why you’re a good candidate to adopt them: *

Submit