Contact:

Melanie Serrao-Durrence   (910)904-6825

bigpawsrescue1@att.net

 

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Application for adoption

THIS APPLICATION IS NOT WORKING, PLEASE CALL ME AT THE NUMBER LISTED OR 

EMAIL ME AT THE ADDRESS LISTED

This application is rather long and in depth. This is so that the dog you adopt will be suited for your home and you will be suited for the dog. The adoption process includes this application and a homecheck.

Please do not press the enter key until you are finished as that you will send me an incomplete application. Please answer all the questions and when finished press the submit button one time.

 

Personal Information:
Name:

Spouse Name:

Email Address:

Address:

City:

State & Zip:

Home Phone:

Work Phone:

I

rent

own

House

Apartment

Condo

Mobile Home

If renting, name and phone number of landlord:

Do you have a fenced yard? 

yes

no

 

If fenced size of yard, height of fence, and type of fence:

This dog would be alone for how many hours in a day?

During the day, the dog will be in the

house

yard

garage

other

Please specify other:

During the night, the dog will sleep in the

What other dogs have you owned in the past 3 years?
 

Breed

Sex

Age

Spay or Neutered?

Still living?

1.

male

female

yes

no

yes

no

2.

male

female

yes

no

yes

no

3.

male

female

yes

no

yes

no

4.

male

female

yes

no

yes

no

5.

male

female

yes

no

yes

no

Are your pets current on all vaccinations? 

yes  no

Are your pets on heartworm preventative?yes no
If you have a dog and it is not altered, why?

Household Information:
# of adults:

# of children:

Ages of children:

Which member(s) of your family will care for the dog?

Does anyone in your family have allergies to dogs?

Tell us a bit about yourself, spouse, children, etc.:

Type of dog you are interested in?
Describe:

Check the traits below that you would like in a dog:

indoor

indoor/outdoor

outdoor

male

female

no preference

under 1 yr old

1-2 yrs old

2-4 yrs old

4-8 yrs old

8+ years

no preference

long hair

short hair

no preference

Why are you interested in this type of dog?

What traits do you feel are essential?

What traits would you consider undesirable? If one of your dogs had one of these traits what would you do?

How long have you been thinking about getting a dog?

Where have you looked for a dog?

Miscellaneous Information:
Name, address and phone number of current veterinarian:

Name, address and phone of last veterinarian:

List 2 references (only 1 relative), including address and phone number:

When you go away who will care for the dog?

Have you ever obedience trained a dog?

yes

no

Explain what training methods and collars you prefer:

Do you realize that most Large Breeds often drool or slobber, and are prone to joint problems?

yes

no

Are you aware we adopt these dogs as house pets only?

yes

no

Have you ever owned this breed?

yes

no

What happened to the dog?

Are you aware that we request a donation for each adoption, to help cover expenses incurred in readying this dog for adoption?

yes

no

 

Are you able to make such a donation?

yes

no

 

Note: In submitting this application, you are attesting to the following statement:

All of the information I have provided in this application is, to the best of my knowledge, true and complete. I understand that falsifying answers in this application, or at any other time during the adoption process, disqualifies me from adoption.

 

 

 

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