Dog Adoption ApplicationAdopt the dog. It change there and your life. Name of dog you are interested in: Your full name: Cell Phone Number: Your email address: Names, genders and ages of all residents of your home and their relationship to you: Does anyone in your household have any known allergies to any kind of animals? YesNo Your address: How long at current address: House/Apartment/Condo? HouseApartmentCondo Rent/Own? RentOwn If you rent/lease, what is your landlord’s name and phone number? Are pets allowed per your lease/rental agreement? YesNo Employer’s Name: How long at your current job? Please provide 2 references (not immediate family) with email, phone number, address and relationship to you: Please list all current pets in your home. Are all pets spayed or neutered and on flea/tick, heartworm prevention and up to date on vaccines including rabies? What characteristics are you looking for? Please include age, size, gender, etc. and why you would like to adopt a rescue dog. Please be specific so that we can find a perfect match for you: Who will primarily care for this dog (feeding, playtime, walks, training, vet visits)? Have you ever surrendered or given away any pet? If yes, please explain the circumstances: Please provide the name, address, and phone number of your current veterinarian. We may contact your vet, please let them know in advance. If you do not have a current veterinarian, who do you plan to use? Do you have a fenced in yard? YesNo If yes, please describe the fenced in area: Rescue dogs may take 3 weeks or more to adjust to a new home. Where do you plan to keep this dog and how long will the dog be left alone during the day? Will you be using a crate? Will you provide basic obedience training or any training if needed by a professional trainer? Be specific: If for ANY reason you can’t keep this dog, he or she must be surrendered back to Beacon of Light Animal Rescue, Inc. There will be no refund of the adoption fee after 30 days from date of adoption. I certify that all information is true and accurate and I understand that any falsification may result in nullification of an adoption. Please sign and date this application and return to: megan.keefe@bolarct.org Signature: Date:
