Adoption Application — Little Red Barn Dog Rescue

Address*

Please include street address, city, state and zipcode

Phone Number

Email

Name of dog applying for

If you are putting in a pre-application, and do not yet have a dog in mind for adoption, please enter "UNDECIDED" in the text field.

Please list names and ages of all permanent residents of your home (adults/children):

Please list all animals owned in the past 5 years, include name, age, and if they are still with you:

If your current pets are not altered or up to date on vaccinations, please explain why below:

Vet reference (please call your vet and give permission to release information to us):

Include Veterinary Name, business, and contact number. If you currently do not have a vet, please let us know if the text field.

Please list two personal references

Include name, contact number, relation, and length of time known.

If yes, from which organization and when?

If you rent, please provide landlord’s name and contact number:

How many hours per day will the dog be alone? Please explain.

How much do you anticipate to spend on your dog per year (for things like veterinary care, licensing, ID tag, food, toys, crate, other supplies, training, pet sitting, etc)?

Who will be primarily responsible for the daily care of the dog?

If you go away on vacation, what will you do with your pet(s)?

Have you ever brought an animal into a shelter? If so, why?

While many animals at the shelter have lived inside before, many have not. Even a seasoned indoor pet can become confused when it moves from one home to another. How do you intend to potty train/litter train/housebreak your new pet?

How do you intend to prevent behavior problems such as barking, chewing, digging, scratching furniture, jumping on furniture, getting into unwanted items, trash digging, etc.?

How do you plan on exercising your dog and what will you do to prevent him/her from roaming?

By signing below, I certify that the information I have given is true and that I recognize that any misrepresentations made may result in my losing the privilege to adopt a pet. I understand that the Little Red Barn Dog Rescue has the right to deny my request to adopt and animal, and I authorize the investigation of all statements in this application.

Please Enter Full Legal Name, this will act as a signature in online documentations.