If you would prefer, print out, complete, and snail mail it to Karen Wingo, Alabama Small Dog Rescue, 403 Hoke Street, Gadsden, AL 35903.
Information on Applicant(s):
Name __________________________________________
Address ________________________________________ _______________________________________________
Employment Address _______________________________ ________________________________________________ _______________________________________________
Phone (H)__________________(W)___________________
Email/Fax _______________________________________
Companion you are applying for:
Name _________________________________________
Breed _________________________________________
Age ___________________________________________
Sex ___________________________________________
Color __________________________________________
Please answer the following questions (use separate paper if needed):
1) Have you ever owned a small dog before?
2) If so, where is that dog now?
3) Would you be willing to accept a different dog (breed, sex, age, color, etc.) than you are applying for?
4) If not, why?
5) Are you familiar with the special needs of smaller breeds?
6) If not, would you be willing to work with one of our volunteers or other professional to learn more?
7) Tell us about your household members.
8) If any members are under the age of 10, have they been taught how to properly handle a small breed dog?
9) What role will the animal be filling in your family?
10) Does everyone in the family agree on getting a companion animal?
11) If not, how will you deal with it in order for the transition to go as smooth as possible?
12) Tell us about any other pets you have.
13) Are they neutered or spayed?
14) Do you rent or own your dwelling?
15) If renting, please give Landlord’s name and phone number.
16) How long have your resided at this address?
17) Do you plan to move in the near future?
18) Do you have a veterinarian?
19) Veterinarian’s name, address and phone.
20) Please give 2 other references that know how you are with animals (name and phone).
21) Do we have permission to contact your references (landlord, veterinarian, personal contacts)?
22) Are you familiar with your local and state laws governing animal ownership?
23) Do you have a fenced in yard, or would be willing to provide an enclosed exercise area?
24) Will the dog be left outside unattended or alone at home for long periods of time?
25) If so, under what circumstances?
26) What accommodations will you make for the animal if you are away overnight or on vacation?
27) Where will the dog reside?
28) Who will be primarily responsible for the animal’s upkeep (feeding, grooming, walking, etc.)?
29) Are you prepared to make a lifetime commitment to this animal?
30) Are you prepared for any messes the animal might make while adjusting to it’s new home?
31) Are you willing to use only positive reinforcement to retrain the dog in case it displays unwanted behaviors?
32) How will you discipline your new companion?
33) Use this section to add anything you feel would be beneficial for us to know.
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Signature of Applicant ____________________________________
Date Signed ____________________
Please note: A non-refundable adoption fee will be charged ($200 to $300) if applicant is approved. This fee is to cover the cost of prior medical treatment the animal received before being placed for adoption. All of our animals are spayed/neutered, up to date on all vaccinations, and on heartworm treatment prior to placement. All potential adopters must agree that if they are approved, and for any reason they can no longer keep the animal, it must immediately be returned to this rescue ONLY. Applicant must also agree to a home inspection prior to final approval.