PA Dog Adoption Application
You must be 21 years of age or older to adopt.
Name of the dog you are interested in:
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Have you Contacted Another Rescue Group? If yes, please list the group name, contact and phone number:
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Are you aware that there will be a non-refundable adoption donation associated with the dog you are applying to adopt, once approved?
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Are you aware that there will be a non-refundable adoption donation associated with the dog you are applying to adopt, once approved?
What is your phone number?
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What is your email address?
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Co-Applicant's Full name:
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What is the Co-applicant's phone number?
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List the names and ages of all persons living in the home:
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If you rent, provide your landlord's full name and phone number:
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Do you have a yard and what type?
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Do you have a yard and what type?
If you have a fenced yard, how high is the fence?
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Is anyone in the home afraid of dogs?
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Does anyone in the home have asthma or dog allergies?
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Current/Previous Pet Information
List all current pets: (Name, species, breed, age)
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Provide the name and phone number of your current/past veterinarian or clinic: (Please call your vet's office to give permission to release records!)
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If no current pets, list pets that you have had in the last 10 years:
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Have you ever given up a pet or had to relinquish one to a shelter?
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Have you ever given up a pet or had to relinquish one to a shelter?
If yes to the above question, explain the circumstances:
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What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)
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Do you have the time to provide adequate love/attention/training/socialization to your new companion?
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Do you have the time to provide adequate love/attention/training/socialization to your new companion?
Do you plan on crate training?
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Do you plan on crate training?
Have you ever house-broken a dog or puppy before?
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Have you ever house-broken a dog or puppy before?
How many hours each day will your dog/puppy be home alone?
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Where will your dog/puppy be when you are at work/not home?
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How will you supervise the dog/puppy's outdoor activity?
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What length of time will you allow your new pet to adjust to their new home? (We strongly recommend that you follow our 3-3-3 Rule for the adoption of a New Pet into your home.)
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Are you willing to work with a trainer to help your new pet's issues, if any?
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Are you willing to work with a trainer to help your new pet's issues, if any?
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?
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Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?
Are you willing to commit to the 3 days, 3 weeks and 3 months of decompression for the best interest of your new pup?
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Are you willing to commit to the 3 days, 3 weeks and 3 months of decompression for the best interest of your new pup?
Do you understand that a dog can be an 18 year commitment, and can be costly to care for?
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Do you understand that a dog can be an 18 year commitment, and can be costly to care for?
Do you or anyone in your household have a history of animal, child or spousal abuse?
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Do you or anyone in your household have a history of animal, child or spousal abuse?
What circumstances would lead you to give up your new dog?
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If under any circumstances you were unable to keep your dog, Animal House Retail for Rescue requires that you agree that the dog will be returned directly to our rescue and will not be rehomed to another party, unless prior written consent is received from us. If the dog is returned to Animal House Retail for Rescue, the adoption donation is non-refundable. Do you agree to these terms?
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If under any circumstances you were unable to keep your dog, Animal House Retail for Rescue requires that you agree that the dog will be returned directly to our rescue and will not be rehomed to another party, unless prior written consent is received from us. If the dog is returned to Animal House Retail for Rescue, the adoption donation is non-refundable. Do you agree to these terms?
List 2 personal references and their phone numbers that are NOT family members or living in the same home as the applicant.
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Please tell us a bit more about yourself and why you think that this dog would be a good fit for your family (and anything else you'd like to add)!
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I will contact my vet's office to give a release of records.
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I will contact my vet's office to give a release of records.
