Adoption Application Please complete this form if you are interested in adopting one of our pets. * indicates required field What dog(s) are you interested in adopting?* Are you familiar with this breed? What breeds do you have experience with? Name:* Age:* Email:* Co-Applicant Name: Co-Applicant Age: Co-Applicant's relationship to Applicant: Who will be primarily responsible for this pet? Address 1:* Address 2: City:* State:* Zip Code:* Daytime Phone Number: Evening Phone Number: Occupation: How long at this job: Number of adults in household?* Number of children under age 4? Number of children age 4-7? Number of children age 8-12? Number of children over age 12? Are you planning to have children in the next 5 years? Yes No Do any children visit your home? Yes No If so, how often? Please indicate where you live: House Apartment Condo/Townhouse Trailer/Mobile Home How long at this address? Do you rent or own? Rent Own Landlord's Name (required if renting): Landlord's Phone Number (required if renting): Are you planning on moving in the near future? If so, when? Is this your first pet as an adult? Yes No Do you currently have other pets? Yes No How many female dogs are in your home? How many male dogs are in your home? How many female cats are in your home? How many male cats are in your home? What are your pets ages? Do you have any other animals? If yes, what kind of animals? Are all of your pets spayed/neutered? Yes No Please provide your veterinarian's name: Please provide your veterinarian's phone number: List any other pets you have owned in the last 5 years: What is the longest period of time you will leave your pet unattended outside? Where will your pet be kept at night? Where will your pet be kept during the day? Where will your pet be kept when family members are not home? How many waking hours do you spend at home each day? Are you familiar with the use of a dog crate to train the pet during your absence or at night? Yes No Are you familiar with how to introduce a new dog into your home? To your children? Strangers? Cats? Would you like advice from a Castaway representative? Will you walk your dog daily? Yes No If not, how will the dog be exercised daily? Has any of your dogs ever been reported for biting a person or another dog? Yes No If yes, please explain: Have you or any member of your household ever been cited for leash law violations or cruelty to animals? Yes No Have you ever sold, given away or surrendered a pet? Yes No If yes, please explain; Does your residence have: (Check all that apply) Yard Fence Dog Run Dog Door Please describe size, height, style, and, and area enclosed of all the items check above: Please tell us a bit about your style of living, including activities which your pet would be included: What experience do you have with basic training/obedience? Do you plan on having your new pet enrolled in obedience training? Yes No Do you have the resources to provide a professional behaviorist/trainer, if needed? Yes No Please add anything you would like us to know: Liability Waiver - I and those accompanying me fully understand the risk during a visit to a foster home or other location. We DO NOT hold Castaway Pet Rescue or its representatives liable for any injury, personal property damage, or other situation which arises as a result of a visit to the foster home or meeting location. Yes No Disclaimer - Castaway Pet Rescue reserves the right to deny an adoption to anyone who, in its opinion, will not provide a suitable home for the pet based upon information provided and investigated/validated in this application. Falsification of information provided will result in automatic denial of adoption.
