Adoption Application

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865 Rescue and Rehome is a non-profit organization. We do have adoption fees for our animals which helps us to cover medical bills, vaccinations, spay/nueter, and other animal needs. All workers with us are strictly volunteers and no fees paid go to any representative of 865 Rescue and Rehome

Information requested in this application is required as staff at 865 Rescue and Rehome is obligated to ensure potential adopters are not only a good match for their new pet, but also to ensure the well being of all adopted pets.

Name

Email

Phone

Address with City and State

Name of Animal You are Interested in.

What is your occupation and name of employer?

What best describes your living situation

House Apartment Townhouse/Condo Other

If Other, please explain. If you live with an HOA or in apartment, what pet restrictions do you have?

If you are not the property owner, we are required to verify any pet restrictions through your landlord. Please provide their contact information here.

Do you have a fenced yard?

Yes No Partial

What is your estimated yard size?

Please list names of all other adults in household. If None, please enter none.

How many children live in the household? What are their ages?

Who will be the primary caretaker of the dog?

Any other pets in the house? Type, breed, and weight.

Do you have a regular vet? Please enter their contact information below.

What best describes your reason for wanting to adopt a dog?

How many hours will the dog be home alone?

Where will the dog sleep at night? (inside, outside, crate, bed)

Where will the dog primarily be during the day? (inside, crate, outside, pet sitter)

What would your ideal dog do on a daily basis?

What are dog habits you cannot tolerate?

Any other notes you would like us to know?

I understand that 865 Rescue and Rehome makes no express or implied warranty, representation or promise to the age, health, breed, habits, disposition or safety of any animal. I will accept the animal as is and assume all risks and responsibilities associated with the ownership of the animal, including bites, and I hereby fully and completely indemnify and hold harmless 865 Rescue and Rehome, its directors, officers, volunteers, and employees from any claim, cause of action or liability of any sort or nature, whether known or unknown, directly or indirectly arising out of or in connection with the adoption, care, or ownership, maintenance, temperament, or condition of the animal.

Yes No