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·. You must be at least 18 years of age or older, or have the consent of a parent or legal guardian.
·. You must be able to provide picture identification which shows your current residence.
·. You must have consent from ALL adults living in the household.
·. If renting, you will need to provide a written consent from your landlord and pay a pet deposit, if applicable.
·. Your pets must have current vaccinations and be free of contagious illnesses. In some instances, we will require that a pet be adopted into a home where special circumstances are required, such as placement of the pet to be the "only pet", or to go to a home where there are "no cats, or even in some cases "no children". This is in the best interest of the animal and your family, based upon the past history/socialization of a pet.
·. You must be willing/able to spend the time necessary to provide training, medical treatment, proper care and cost, and companionship for the pet.

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Name of animal being applied for:

Your name:

Your street address:

City: State: Zipcode:

Your e-mail address: Your homephone:

What is your work phone #:

Employer's Name/Address:

Length of time at current employer:

Spouse's Name:

Spouse's Employer:

Please tell us about your home: (Please put yes or mark the appropriate box)

Mobile Home:

Rent :
Other :

If you rent, does your lease state that you are allowed to have pets :

Landlord's Name :

Landlord's Telephone Number:

Is your yard, or an area in your yard, fenced for the animal?:

Fence Dimensions/Type:

What accommodations do you have for the animal's exercise and toilet duties?:

Names of all adults living in the household?

Names of children & their ages?

Is everyone in the household agreeable on a new pet?

Is anyone home during the day?

Is anyone in the household allergic to?
other critters:

Have you ever housebroken an animal before?

If necessary, would you enroll/attend obedience classes with your animal?

Where will the animal be kept during the day?

Where will the animal be kept at night?

How long will the pet be left home alone during the day/nightand how many days per week?

Do you plan on chaining this dog?

Why do you want to adopt this pet?

List all pets you currently have and have had for the past five years, including breed; if they aren't still with you, explain why in detail:
pet 1:
pet 2:
pet 3:
pet 4:
pet 5:

Are you pets spayed/neutered?

Do your current pets get along with other animals?

Name/address/telephone numberof your vet or vet you intend to use:

Name of groomer/boarder and telephone number, if applicable:

Please list three personal references/address/telephone number (no relatives please):
reference name:

reference name:

reference name:

Rescue animals require that you have patience, understanding,and lots of love to devote to them. Some have been abused, some were found as strays, and some were given up by their previous owners.In most cases, it will take some time for them to learn to trust their newowners because they feel they have been abandoned in some way previously.Some are housebroken. Some are crate trained. You must be willing to be patient to their needs and willing to teach them basic obedience commands, housebreaking, and socialization skills.

I, , have provided true and correct information on this application. I understand that an adoption fee applies and that if approved, once the animal has been adopted it is my sole responsibility to provide necessary vet care for that pet (emergency vetting & maintaining routine exams/necessary shots & license the animal as required by my locale). In the event I am unable to keep the pet for any reason, it will be returned to In His Hands Dog Rescue,no questions asked, however, adoption fees and vetting that I have incurred WILL NOT be refunded. I further understand the information I've provided will be investigated to ensure an appropriate placement for the prospective animal. A preliminary home visit will be conducted, and subsequent home visits will be conducted if I am approved to adopt an animal. The primary mission of In His Hands Dog Rescue is the welfare of the animals accepted in to the organization, therefore, are required by law to ensure the best possible placement for each of their animals based upon the special needs of each individual animal.

Name of applicant filing this form: