Adoption Application

Personal Data

First Name: *

Last Name: *

Address: *

City: *

State: *

Zip: *

If the dog you are interested in isn't available, would you consider another?:

Date of Birth: *

Please list the dogs you are interested in adopting:

Spouse/Partner First Name:

Spouse/Partner Last Name:

Spouse/Partner Date of Birth:

Your Occupation:

Spouse/Partner Occupation:

Home Phone: *

ex. (000) 000-0000

Work Phone:

Cell Phone:

Best Time to Call: *

Email: *

Alternate Email:

How did you hear about us?:

Preferences

What are your preferences?

Breed Type:

Age:

Sex:

Would you consider:

Are you familiar with the characteristics and temperament of this breed?:

If so, how:

Are you prepared to adopt a rescued dog without knowing what its background is?:

Household Information

Are there any other adult members of this household?:

If yes, please input their ages:

Do you have children?:

If yes, please input their ages:

Do they live with you?:

Have they been taught to appropriately interact with dogs?:

Are there any children that don't live with you but visit often?:

What kind of dwelling do you currently live in?:

If other, please specify type:

Do you rent or own your home?:

How long?:

If you rent, do you have permission to have pets?:

May we contact your landlord?:

Landlord/Owner Name:

Landlord/Owner Phone:

Do you have a pet door?:

Do you have a fence?:

Fence Height:

What type of fence? :

Do you have locks on your gates?:

Do you have a pool?:

Is your pool fenced? :

Are you willing to install a "Safety Turtle" pool alarm? :

Your home is usually:

What are your reasons for adopting a dog?:

Past and Present Pet History

How many pets have you owned in the past 10 years?: *

Briefly describe what happened to the pets you no longer own:

How many DOGS do you currently own?:

Where do your current dogs sleep at night?:

Please list all current dogs

Dog 1

Name:

Sex:

Altered:

Breed:

Age:

How long owned?:

Kept Inside or Outside?:

Dog 2

Name:

Sex:

Altered:

Breed:

Age:

How long owned?:

Kept Inside or Outside?:

If you currently own more than two dogs, please enter their information here :

Do you own any cats?:

If so, how many?:

Training

Are you willing to work on house training/behavioral issues when the new dog first comes into your home?:

Are you familiar with crate training?:

If yes, what are your feelings about it?:

Are you willing to buy and use a crate, or other confinement, if recommended?:

Are you willing to take this dog to obedience class, if recommended?:

If this dog demonstrates destructive behavior (chewing furniture, etc) what measures will you take to solve the problem?:

Pet Care and Responsibility

Who will be primarily responsible for the dogs care?:

How many hours on average daily will your dog be alone?:

The dog will spend it's time while I'm away::

At night the dog will sleep::

Are you prepared to pay up to $40.00 every 4-6 weeks to groom your pet?:

If your dog needed acute medical attention or emergency care, are you prepared to handled that expense?:

If your dog developed an illness and required monthly medication, up to what amount are you comfortable spending?:

Are you familiar with heartworm disease?:

If you own a dog, what is your current heartworm prevention program?:

Are you familiar with the leash and licensing laws in your community?:

How will you transport your pet?:

Under what conditions would you give up your dog?:

If you currently have a dog, what type of food do you feed?:

If a higher quality brand was recommended, but more expensive, would you be willing to change?:

If no, why not?:

What would happen to dog(s) if your family situation changed (divorce, relocation, death)?:

Have you ever given away/sold/released an animal to a shelter or rescue organization?:

If so, what were the circumstances::

Do you travel a lot?:

Where will your dog(s) stay when you are away?::

Personal References

(no more than 1 family member please)

Reference 1

First Name: *

Last Name: *

Relationship: *

Address:

City:

State:

Zip:

Phone: *

Email:

Reference 2

First Name: *

Last Name: *

Relationship: *

Address:

City:

State:

Zip:

Phone: *

Email:

Veterinarian Information

First Name:

(if none, put n/a)

Last Name:

(if none, put n/a)

Clinic Name:

(if none, put n/a)

Phone:

(if none, put n/a)

Is this the vet you currently use?:

Yes

Permission Agreement: *

I give permission for a DFW Tzus & More representative to visit my home prior to adoption to do a home check and after adoption to do follow up checks, with notification, on my adopted pet if deemed necessary by a DFW Tzus & More representative.

Information Agreement:

All of the information provided on this application is true and complete to the best of my knowledge. I give permission for a DFW Tzus & More representative to verify that the information is true and correct. Any misrepresentation of the truth in this application will invalidate any subsequent adoption agreement and will give DFW Tzus and More the right to reclaim the adopted pet without refund.

Rights Agreement:

I understand that DFW Tzus & More Rescue does its best to match each dog to the right home. Therefore, if DFW Tzus & More Rescue feels the dog and applicant are not compatible, it retains the right to deny this application.

Dallas-Fort Worth Shih Tzu Rescue & Lhasa Apso Rescue “Dedicated to helping homeless pets find their way home.”