istandwithmypack.org
Dog Adoption Application/Contract
Please finish the following contract in its entirely. Thank you!
Date:______Name of desired dog:______
Personal Information:
Name:
Age:
Occupation:
Spouses name:
Spouses occupation:
Name/ages of children:
Other occupants in home:
Home address:
City:
State/province:
Zip/postal code:
Home phone:
Mobile phone:
E-mail address:
Type of Residency:
Do you personally rent or own?
Is there a size/weight limitation? What is it?
If renting, do you have landlord’s permission to have a dog?
Landlord name and phone number:
How long have you resided at this location?
Primary reason for wanting a dog:
If other, please specify:
If you have children, please describe their previous experience with dogs:
If your children did not want a dog, would you be interested in adopting one for yourself?
Are you planning on having children in the future? If so, when?
Does anyone in your household have allergies? If yes, describe:
Current Pets:
Do you have a pet now? How many?
List type of pets (if dog, list breed); age(s) and sex(es):
How long owned?
Where did you get your current pets?
How many dogs live at, or are present at your residence and what is the breed of any such dog?
Do your animals have any physical issues?
Do your animals have any behavioral issues?
Do your animals get along with (other) dogs?
Have you ever had multiple dogs in your home?
How did you feed them?
Did you have toys and/or bones around?
How many dogs stay overnight at your residence and what is the breed of any such dog?
Are your pets spayed/neutered?
Have you ever allowed an animal to breed?
Have you ever had to surrender an animal to a shelter or rescue group?
If yes, please explain:
Is there anybody home during the day? Who?
When will the dog be inside? Outside?
About how many hours will the dog be left alone?
Where will the dog stay when he/she is home alone?
Where will the dog sleep at night?
If inside, where exactly?
If other or if you have additional comments on where the dog will sleep, please specify:
What rooms are off limits to the dog?
What outside areas are available to the dog?
If other, please specify:
Do you have a doggie door?
Type of fencing:
Height of fence? List highest point and lowest point:
I have recently inspected my fences and they are good condition:
The fence is intact on all sides and is at least 6 feet from the ground level in all areas:
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:
Are there gates?
How many gates?
How high?
Type of lock:
Is there any type of lock on the gate (s)?
If no locks, would you be willing to install them prior to placement should this application be accepted?
Do you have a swimming pool?
If yes, is swimming pool surrounded by a gate?
Who has access to your yard?
If other, please explain:
Preferred level of exercise with dog:
How would you socialize your dog?
When you go on vacation, who will care for the dog?
Are you moving or traveling in the next 12 months? Please explain:
What kind of food will you feed the dog?
Can you afford to provide medical care, grooming, proper diet, shelter, and exercise for your new pet?
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?
Do you have a regular vet?
Name of vet:
Would you like a referral to a vet?
Who will groom and bathe your dog?
Would your dog wear a collar?
When?
Your Past Experience
How would you rate your level of dog owning experience?
If other, please explain:
How would you train this dog?
If other, please explain:
How would you discipline your dog if he or she misbehaved?
What, if any, behavioral issues have you dealt with in the past?
Have you ever had any of your own dogs get into a fight?
If yes, please explain:
Would you bring in a trainer that deals with dog aggression?
Would you be willing to seek professional dog training or obedience classes at your own expense?
How do you normally walk your dog? On leash, off leash:
When on leash do you normally use:
If other, please specify:
If your dog escaped from your home, what steps would you take to find him/her?
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?
What would happen to your pets if you moved locally?Out of state?Out of the country?
Which of the following reasons might prompt you to give up your dog?
Comments:
Please list pets you have owned since you have been an adult and the length of ownership:
If your present relationship was to change or there was a death in the family, with whom will the dog go to?
How did you find out about our adoption program?
Why are you interested in adopting from a rescue?
Please initial all that apply:
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 charitable contribution of $300: ______
I agree to provide my own collar, leash, corrective collar or harness, and a personal ID tag at the time of completing the adoption contract:______
I Stand With My Packreserves the right to refuse adoption to any applicant for any reason. This questionnaire becomes part of our contract.
Terms and Conditions
1. Adopter agrees to pay ISWMP an adoption fee of $______above named dog(s). Adoption fees are non-refundable after 10 days.
2. Adopter agrees the dog is to be a family companion and agrees to provide the dog with a safe home, adequate food, water, proper care, exercise, love and attention. Adopter agrees not to violate any laws or ordinances with the dog.
3. Adopter agrees NEVER to declaw the dog for any reason.
4. Adopter agrees to notify ISWMP IMMEDIATELY if the dog is lost, stolen, hurt or killed.
5. When the Adopter is to go away for any prolonged periods of time or vacation, Adopter is to prearrange proper care for the dog.
6. The dog is not to ride loose in the bed of pickup trucks, convertibles, or to be left in a car unless the car remains on with the air conditioner on and the doors locked.
7. The dog is to remain indoors at all times unless in a safe, escape-proof enclosure or dog carrier.
8. Adopter agrees to have the dog examined by a licensed veterinarian at least once each year and provide all vaccinations and treatments, including dental, to ensure good health. If euthanasia becomes necessary, Adopter agrees to have it performed by a licensed veterinarian.
9. Adopter agrees to notify ISWMP of a change of address and/or phone number within two weeks of such change. Adopter agrees to keep microchip up to date at ALL times.
10. ISWMP makes no guarantees or statements regarding the dog’s age, breed, health or temperament. While ISWMP has made every effort to provide accurate history assessment of the dog, ISWMP is not able to guarantee the dog’s age, breed, medical status, behavior or disposition. Adopter accepts this dog as is with all defects, either observable or unobservable, and assume all risk for the dog upon signing this contract.
11. If for whatever reason the Adopter is unable to keep this dog for its entire life, the Adopter MUST return the dog to ISWMP. ADOPTER AGREES NOT TO GIVE AWAY, SELL, OR DISPOSE OF THE DOG WITHOUT EXPRESS CONSENT OF ISWMP, or adopter may be subject to a $25,000 fine.
12. Adopter will allow ISWMP to conduct phone check-ins and inspections at ISWMP’s discretion after adoption in order to check on the dog’s welfare.
13. ISWMP has the right to take the dog back into the Rescue if the owner does not agree to and comply with ALL terms and conditions. The contract is not signed. The agreed upon adoption fee is not paid. We feel the dog is unsafe in the Adopter’s home, or we feel the dog is not the right fit for home/lifestyle.
Adopter’s Signature: ______Date: ______