Dog Adoption Application

Doberman Adoption Application

This questionnaire is designed to help determine if a specific dog is the right one for you and your household.
J9's Rescue is an all-volunteer, non-profit, animal welfare organization dedicated to the rescue and placement of rescued Dobermans and Bunnies. J9's Rescue is completely funded through fundraising efforts and public donations. All of our animals are cared for by foster homes and receive complete medical care, which includes worming, vaccinations, spaying/neutering, and microchipping before their adoption.
All adopting parties are required to complete this form prior to adoption. J9's Rescue reserves the right to deny any adoption based on answers to this questionnaire and/or interviews.
The name of the dog you are interested in:*
Applicant Information
First Name*
Last Name*
Your age:*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
E-mail:
Family & Household Information
1. Type of home you live in?

Apartment / CondoTown HomeSingle FamilyFarm
2. Do you own or rent?

OwnRent
a) If you rent, please provide the name of your landlord:
b) If you rent, please provide the phone number of your landlord:
3. Are there any restrictions from your city?

Number of petsBreed restrictionsNoneI Don't Know
4. Do you have a fully fenced yard?

YesNo
a) Height and type of fence:
4. Please describe your household:

ActiveNoisyQuietAverage
5. Are all members of your household in agreement with this adoption?

YesNoDon't Know
6. How many adults are in your household?
7. How many children are in your household?
a) If children, what are their ages?
b) If Children, have they been around animals before?

YesNo
8. Does anyone in your home have allergies to dogs or have asthma?

YesNo
Veterinarian Information
9. Do you have a regular Vet?

YesNo
a) Please provide the name and address of your current and/or previous veterinarian or clinic:
b) Vet / Clinic's Phone Number:
10. Do you agree to provide regular health care and keep vaccinations up to date?

YesNo
Current/Previous Pet Information
11. List any pets you currently have, types/ breeds and their ages:
12. Are these pets spayed/neutered?

YesNo
a) If No, why?
13. Have you adopted from an animal welfare group before?

YesNo
a) If Yes, what group?
14. Have you ever given up a pet?

YesNo
a) If Yes, what were the circumstances?
New Pet Information
15. What type of personality do you want the new dog to have? (i.e. calm, energetic, protective, couch-potato)
16. Are you aware of crate training?

YesNo
17. How many hours each day will the new dog be home alone?
18. Do you agree to keep the new dog on monthly heartworm protection all year long?

YesNo
19. Are you willing to work through the new dog's issues, if any?

YesNo
20. Are you aware that a new environment is stressful for the new dog, and they may exhibit uncharacteristic behavior?

YesNo
21. Do you plan to take an obedience class with your new dog?

YesNoNot sure
a) If yes, where?
22. What circumstances would lead you to give up your new dog?
23. If you had to give up your dog, what would you do with him/her?
Personal References

Please list a references familiar with both you and your pets.
References Name

First NameLast Name
References Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
References Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
References Email
example@example.com
Relationship
Almost Done!
24. Are you willing to let a representative of J9's Rescue visit your home for a "home check" by appointment?

YesNo
25. How did you find out about J9's Rescue?

Adoptapet.comFacebookFriend/Family MemberJ9sRescue.comDoberman Gang of DetroitPast AdopterOther
All of the information I have given is true and complete. The dog will reside in my home as a pet. I will provide him/her with quality dog food, fresh water, indoor shelter, affection, annual examination and vaccinations by a veterinarian.

I agree
DateTime
Should be Empty:

Doberman Adoption Application

Applicant Information

Family & Household Information

Veterinarian Information

Current/Previous Pet Information

New Pet Information

Personal References

Almost Done!