Recycled Poms and Schipperkes

ADOPTION APPLICATION  

(cut & paste to e-mail)

Thank you for your interest in adopting a rescued Pomeranian or Schipperke. The following is a pre-adoption application that all of our potential adopters must complete. 

Recycled Pomeranian Rescue Inc. (SOS RESCUE)

 Return to Revbitting@aol.com

 Date:_______________   

 Interested in:_________________   

 Applicant’s Name:______________________________

Email:____________________

Present Address:_________________

City:_______________

State_____ Zip ________

How long at this address? _________ Years ________Months

Home Phone #: __________________

Work Phone #: ___________________

Work E-mail:______________________

I live in a: ___House ___Duplex ___Apartment ____Condo ____Mobile home ____Other ___I rent ___I own

I have other living arrangements: _________________

Do they allow pets? Yes / No

Name of Manager/Landlord _______________________

Contact phone #:_______________________

Any restrictions on pets? __Yes / __No

Explain:________________________

Do you have a fenced yard? __Yes / __No

What kind of fence? _________________

Height? _________

Are you planning on moving in the near future? __Yes / __No

If you move, what would you do with your pet? __Yes / __No

Are you under 18 years of age? __Yes / __No

Will others be handling or caring for this pet? __Yes / __No

If yes, how many? Adults_____ Children ______

Ages of all household members: ____________

Do any members of your household have allergies? __Yes / __No

List all of the pets you have now, including roommates’ pets:

# Dogs: _______ Breed: ____

Indoors? __Yes / __No Altered? __Yes / __No

# Cats: _______ Breed: _____

Indoors? __Yes / __No Altered? __Yes / __No

Have you had any other pets in your adult life?___________

If yes, how long did you own them and what happed to them? ______________________

If you currently have other pets, or if you previously had pets in your adult life (within the past 5 years), please list:

Veterinarian’s name: _______________________

Office Name:______________________________

Phone Number:_________________________

Please list 2 personal references including phone numbers:

________________________________________________________________________________

________________________________________________________________________________

Have you adopted any pets from another rescue or animal shelter in the past?

 __Yes / __No

If yes, which one? __________________

Are you interested in a: ___Dog ___Puppy

Before seeing the dog that you are applying for, what kind of dog were you looking for and what traits are you looking for in a dog?

________________________________________________________________________

I want this pet for: ___Breeding ___ Child's pet ___Gift ___Companion ___Hunting ___Mouser ___Guard dog ___Working/Farm ___Companion for other pet ___Other, Explain:_________________________________________________________________

What is the activity level of the dog you are looking for? ________________________

What will you do if the dog displays bad behavior such as barking, digging, chewing, biting, etc?___________  

 What time period would you require preparing for your new dog?

 _____ days ____none, _______ready now!

 My dog will be kept mainly: ___ Outdoors ___Indoors ____Both, in & out ____other

How long will your dog be left by itself each day? ______ hours

When I am gone, my dog will stay: ___Outside ___In a crate ____In a restricted area ___free in the house _____ access to a doggie door

 If you live in the country, how will your dog/puppy be confined? ____________________________________

Do you or any of your neighbors have livestock? ___Yes / ___No

Who will be responsible for the socialization medical care and training of this animal? ___________________

Who will be housebreaking this pet? _________________

How? ___________________________________

Where will your dog sleep at night?______________________

 There are times when unexpected and often very expensive medical conditions occur. Are you committed to providing whatever medical care your veterinarian deems necessary for you dog? _____________________.

Would you be willing to allow a representative of the rescue to visit your residence? ___Yes / ___No

 I, the undersigned, do hereby certify that the information above is truthful and correct. I do understand that the minimum adoption donation is $250.00 in order to help offset the vet bills that the rescues incur. All dogs have had all of their shots, been heartworm tested and kept on preventative, and been spayed or neutered prior to adoption.

_________________________________________       ___________

Signature                                                                          Signature Date

By submitting this application, I hereby certify that the information on this application is true.

Recycled Poms and Schipperkes
OUR DOGS ARE IN FOSTER HOMES IN THE METROPLEX AREA