Catahoula Rescue Southeast
WWW.ADOPTAHOULA.COM
ADOPTION APPLICATION
After you have completed the application and submitted it, please be patient--it may be at least several days before you hear back from a representative. We do not place our dogs on a "first come, first served" basis, but according to the needs of the dog. This Application is not a contract or an agreement.
APPLICANT INFORMATION:
APPLICANT’S FULL NAME:SPOUSE/PARTNER OR ROOMMATE NAME:
AGE OF APPLICANT:
ADDRESS:
CITY AND STATE:
ZIP CODE:
COUNTY:
EMPLOYER NAME:
HOME PHONE:
CELL PHONE:
WORK PHONE:
EMAIL ADDRESS:
DOG YOU ARE INTERESTED IN:
NOTE: Before adoption is approved, a home visit will be conducted by one of our volunteers to make sure the dog is placed in a safe environment.
HOUSEHOLD INFORMATION:
1. HOW MANY CHILDREN IN HOUSEHOLD AND THEIR AGE:
2. PLEASE LIST ALL OTHER MEMBER’S OF YOUR HOUSE HOLD; INCLUDE THEIR AGES & RELATIONSHIP TO YOU:
3. IS ANYONE IN YOUR HOME ALLERGIC TO ANIMALS?
4. WHAT QUALITIES ARE YOU LOOKING FOR IN YOUR NEW DOG? WHAT ARE YOU TRYING TO AVOID?
5. DO YOU OWN YOUR HOME OR RENT? IF RENTING PLEASE PROVIDE YOUR LANDLORD’S NAME & PHONE NUMBER.
6. WHAT TYPE OF HOME DO YOU LIVE IN & HOW LONG HAVE YOU LIVED THERE (house, condo, townhouse, apartment, trailer, rent a room, etc.)?
7. IS THE AREA IN WHICH YOU LIVE SUBURBAN, RURAL OR URBAN?
8. IS YOUR YARD COMPLETELY FENCED? IF SO, DESCRIBE. Applicant’s fence must be at least 6 feet tall, in good repair, free from holes and gaps where a dog could escape.
9. IF NO FENCE HOW WILL YOU HANDLE EXERCISE & BATHROOM TIME?
10. ARE THEIR REGULAR VISITORS TO YOUR HOME (human & animal) WHICH YOUR NEW DOG MUST GET ALONG? EXPLAIN.
11. PLEASE LIST ALL YOUR CURRENT & PREVIOUS PETS YOU HAVE OWNED IN THE LAST 10 YRS, PLEASE INCLUDE:
Pet’s Name / Breed / Gender / Age / Years Owned12. FOR EACH PET WAS IT SPAYED OR NEUTERED? YES / NO
13. UP TO DATE ON ALL VACCINATIONS? YES / NO
14. ON HEARTWORM AND FLEA/TICK PREVENTION (what are the names of the products)?
15. DO YOUR DOGS HAVE ANY OF THE FOLLOWING, PLEASE EXPLAIN:
· PHYSICAL PROBLEMS?
· BEHAVIOURAL PROBLEMS?
· DOMINANCE PROBLEMS?
16. IF ANY PET YOU HAVE OWNED WITH IN THE LAST 10 YRS IS NO LONGER WITH YOU WHAT HAPPENED TO THEM, BE SPECIFIC?
17. ARE YOU MOVING AND IF SO WHEN?
18. HAVE YOU EVER OWNED A CATAHOULA BEFORE?
19. WHAT DO YOU KNOW ABOUT THIS BREED?
We want to make sure you fully understand what to expect from a Catahoula and that the dog you choose is a perfect fit for you and for the dog.
20. LIST ALL PLANS FOR THIS DOG:
Pet / Companion:Gift:
Hunting:
Herding:
Guard
To Breed:
Other, Describe:
21. FOR WHOM ARE YOU ADOPTING THIS PET FOR (self, friend or relative)?
22. WHERE WILL YOUR DOG SPEND ITS DAY WHEN YOU ARE NOT HOME? BE SPECIFIC.
23. WHERE WILL YOUR DOG SPEND ITS DAY WHEN YOU ARE HOME?
BE SPECIFIC.
24. WHERE WILL YOUR DOG SPEND ITS NIGHTS? BE SPECIFIC.
35. ON THE AVERAGE HOW MANY HOURS WILL THE DOG SPEND ALONE?
If the dog is to be left in a crate the crate must be a minimum of 48 inches. With enough room for the dog to be able to turn around and lay down.
36. UNDER WHAT CIRCUMSTANCES DO YOU THINK IT IS PERMISSIBLE TO ALLOW A DOG OFF LEASH? Shock collars are not allowed
37. HOW DO YOU FEEL ABOUT PETS ON FURNITURE?
38. DO YOU OWN A DOGGIE DOOR? Doggie doors are not allowed if the dog will have free access to the backyard when the applicant is not at home.
39. ARE YOU WILLING TO GIVE THIS NEW PET ENOUGH TIME (some take 30 days or more) TO ADAPT WITH HIS/HER NEW ENVIRONMENT AND FAMILY MEMBERS?
40. DO YOU UNDERSTAND SOME RESCUED ANIMALS CAN COME WITH SEEN OR UNSEEN TRAUMAS, FEARS, BEHAVIOUR PROBLEMS, ETC; SOME OF WHICH MAY NOT BE IMMEDIATELY APPARENT?
41. HOW DO YOU PLAN TO HOUSE TRAIN YOUR DOG?
42. DO YOU UNDERSTAND THAT CHANGING A DOG’S ENVIRONMENT MAY CAUSE THE DOG TO HAVE ACCIDENTS?
43. HOW WILL YOU HANDLE BARKING, CHEWING, SCRATCHING & DESTRUCTION, BE SPECIFIC?
44. IF NECESSARY HOW WILL YOU DISCIPLINE THE PET (BE SPECIFIC)?
45. IF YOU DO MOVE IN THE FUTURE WHAT WILL YOU DO WITH THE DOG?
46. WHEN YOU GO ON VACATION WHO WILL TAKE CARE OF THE DOG?
47. IN THE CASE OF AN EMERGENCY SUCH AS TORNADO, HURRICANE, FLOOD OR ANY OTHER ACT OF GOD, WHAT ARE YOUR PLANS TO EVACUATE WITH YOUR PET?
48. ARE YOU PREPARED WILLING AND ABLE TO PROVIDE THE FULL COST OF CARE FOR THIS PET INCLUDING; EMERGENCY AND ROUTINE VET CARE (HEARTWORM PREVENTION), DOG FOOD, GROOMING, TOYS AS WELL AS THE TIME & EFFORT REQUIRED?
49. HOW MUCH DO YOU ANTICIPATE SPENDING YEARLY TO FEED, VACCINATE, LICENSE AND MEDICAL CARE FOR THE PET?
50. HAVE YOU EVER OWNED A RESCUED ANIMAL, IF SO WHERE DID YOU GET IT?
51. DO YOU LEAVE FOOD OUT ALL DAY FOR THE PET OR FEED AT CERTAIN TIMES, HOW MANY TIMES A DAY? Dogs must be fed 2x per day
52. WHAT IS THE NAME OF THE DOG FOOD AND WHAT KIND?
53. HAVE YOU EVER GIVEN AWAY AN ANIMAL TO A SHELTER, RESCUE GROUP OR PERSON? WHY?
54. LIST THE TYPES OF BEHAVIOURS YOU MIGHT FIND DIFFICULT TO LIVE WITH OR INTOLLERABLE.
55. WHAT CIRCUMSTANCES MIGHT YOU CONSIDER GIVING UP YOUR PET (divorce, moving, baby, medical problems, not getting along with other pets, to time consuming, etc)?
56. PLEASE DESCRIBE WHAT A TYPICAL DAY AND TYPICAL WEEK WILL BE FOR YOUR PET.
57. WHAT ELSE CAN YOU TELL US ABOUT YOURSELF?
58. WE REQUIRE A HOME VISIT PRIOR TO ANY ADOPTION, IS THIS ACCEPTABLE TO YOU?
Note: During the home visit our volunteers will make sure that the home is a safe environment for the dog.
· Fence conditions will be checked
· size of crate will be verified
· General safety of living conditions will be checked.
REFERENCES:
1. VETERINARY REFERENCE REQUIRED:
If you do not have a vet, please list one that you will be using
Name of your Vet:Phone Number:
Name in which the pet is registered and name of pet:
2. FIRST PERSONAL REFERENCE: address, phone, best time to contact, years known and relations to you. No family members, please
3. SECOND PERSONAL REFERENCE: Name, address, phone, best time to contact, years known and relations to you. No family members, please
WE RESERVE THE RIGHT, IN OUR SOLE DISCRETION, TO REFUSE ANY APPLICANT FOR ANY REASON WHATSOEVER
CRI SEis under NO obligation to adopt an animal to any individual.
Many factors go into determining which applicant will be matched with a particular animal. If you are not chosen for this pet, it does not mean that you are not considered a good pet owner or that your home is not acceptable. Our goal is to place this animal in the home that will best suit its needs.
Our adoption process is the same for everyone and it is not our intent to frustrate you. Rather, everything we do is in the best interests of the animals in our care. Our goal is to give them the best possible chance of finding a permanent, safe and loving home. Our adoption policies are based on our experience and the experience of many other rescues.
Digital Signature
Applicant: I acknowledge that all of the above information is true, complete and accurate to the best of my knowledge. If any of the information changes, I/we will advise you promptly. I understand that any omission of information requested, or any false or misleading information may result in the rejection of my application and/or may be considered justification for the removal of my adopted pet if discovered at a later date.
Applicant name (acts as legal signature) and date.
PLEASE EMAIL APPLICATION TO:
CATAHOULA RESCUE SOUTHEAST
WWW.ADOPTAHOULA.COM
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