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C.U.R.S. ADOPTION APPLICATION If you are interested in adopting a dog from C.U.R.S. please complete this application and return it to the address provided below. This will help us match the dog to an appropriate home, and ensure that he/she will be the best dog for you, your family and your lifestyle. It is very important that we find the correct home for each dog. Completing will help us determine which dog will best suit you. Please include your check when you mail the application. Please fill out ALL of the information requested. An incomplete application will be discarded. 1. Please provide the following contact information: Name of Dog you are interested in: _________________ Name __________________________________________ Street address ___________________________________ Address (cont.) __________________________________ City __________________________ State _________________________ Zip code ______________________ Work Phone _______________________________ Home Phone _______________________________ E-mail ____________________________________ 2. How long at current address? ____________________ 3. Where are you employed? ________________________ 4. How many adults are in your household?_____________ 5. Occupation/s? __________________________________ 6. How many children are in your household? ____________ 7. What are their ages? _____________________________ 8. What type of area do you live in? _____ City 9. What type of housing? _____ Apartment _____ Condo 10. Do you rent or own your home? _____ Rent _____ Own 11. If you rent or lease, do you have permission from your landlord to own a dog? (Please attach a copy of your lease or rental agreement which shows that pets are permitted and/or a copy of a letter from your landlord granting you permission to have a dog). 12. What other dogs have you owned? _________________ _________________________________________________ _________________________________________________ _________________________________________________ 13. What happened to them? ________________________ _________________________________________________ _________________________________________________ _________________________________________________ 14. What animals do you currently own? _______________ _________________________________________________ _________________________________________________ _________________________________________________ 15. Are your animals spayed/neutered? ____ Yes _____ No 16. If no, why? __________________________________ _________________________________________________ 17. Are your animals on heartworm preventative? ____ Yes ____ No 18. If no, why? ____________________________________ __________________________________________________ 19. What do you know about this particular breed? _______ __________________________________________________ __________________________________________________ 20. Do you have a fenced yard? _____Yes _____ No 21. If yes, what is the height of the fence? _____ 4 feet 22. Describe your fence (type, construction, etc.) _________ __________________________________________________ __________________________________________________ __________________________________________________ 23. If you don't have a fence, where and how will the dog be exercised and allowed to eliminate? __________________________________________________ 24. What member of the family will be taking the MAJOR responsibility for caring for this pet? __________________________________________________ 25. What are your plans and goals for this dog? ___________ __________________________________________________ __________________________________________________ __________________________________________________ 26. Have you ever trained a dog in obedience classes? 27. Will you take your dog to an obedience class? 28. Will the dog live in the home? _____Yes _____ No 29. Where EXACTLY will the dog sleep at night and be kept when there is no one at home? __________________________________________________ __________________________________________________ 30. Do you believe in dog crates? _____ Yes _____ No 31. What are the major activities, hobbies, or exercises you and your family most participate in? __________________________________________________ __________________________________________________ __________________________________________________ 32. When you go on vacation, where will your dog go and who will care for it? __________________________________________________ __________________________________________________ 33. If you move, what will you do with your dog? _________ __________________________________________________ __________________________________________________ 34. Who is the veterinarian that you have or would use? Please provide all information: Name ______________________________________________ Business Name ______________________________________ Street address _______________________________________ Address (cont.) ______________________________________ City ___________________________________ State ___________________________________ Zip code ________________________________ Phone __________________________________ 35. May we call your Vet and ask how you take care of your animals? __________________________________________________ __________________________________________________ 36. Are you willing to allow a representative to periodically visit your home? If no, why? __________________________________________________ __________________________________________________ __________________________________________________ 37. Please list the name, address, and phone number of one (1) personal reference (not related) that you have known for at least two (2) years: Name ______________________________________________ Street address _______________________________________ Address (cont.) ______________________________________ City _______________________________________ State ________________________________ Zip code _____________________________ Home Phone __________________________ 38. Please list the name, address, and phone number of a second personal reference (not related) that you have known for at least two (2) years: Name ______________________________________ Street address________________________________ Address (cont.)_______________________________ City ________________________________________ State ________________________________ Zip code _____________________________ Home Phone __________________________ 39. Please tell us a little about yourself, why you want this dog, and why you feel you could provide a good home for a dog. ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ I hereby affirm that all of the above information is true and correct. I understand that submission of this application does not necessarily mean that I will be approved to adopt and that you reserve the right to reject any applicant. I authorize you to verify any and all information set forth in this application and to contact my personal references.
Signed: _____________________________________
Date: _______________________________________
Thank you for completing our Adoption Application. Our first contact with you will be by email to the address you provided. Typically we will respond within 24 to 72 hours after receipt of the application. Please do not telephone as that will not result in any faster of a response. Please return completed application to: C.U.R.S., Inc., via fax: 703-267-2359 To adopt one of C.U.R.S. rescues: An Adoption Application must be completed, submitted & approved. An adoption contract and a tax deductible donation (to help cover vet expenses) will also be required. We reserve the right to reject any applicant. Donations are non-refundable.WE RESERVE THE RIGHT |
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Copyright 2005-2006 Catahoula United Rescue Society, Inc. All rights reserved. |
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