Obsolete Chasin' Tail Rescue Adoption Application Form

Obsolete Chasin' Tail Rescue Adoption Application Form

This form is no longer in use Please go to Chasintailrescuenc.com and follow the link there
Adopter

First Name Last Name
Co - Adopter

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail
Phone Number

Area Code Phone Number
How did you hear about us?
What made you decide on a dog?
Type of dwelling:
How long have you lived there?
Do you have a fence that is secure?

Yes No
Have you had dogs before?

Yes No
Have you ever had to give up a dog?

Yes No
If yes, for what reason?
Is everyone in household in agreement to adopting an animal?

Yes No
How many other pets do you have and what are they?
Anyone in household allergic to animals?

Yes No
Who will train, feed and exercise the animal?
Where will the dog be kept at night?
Will the dog be tied up?

Yes No
Who is your Vet? Please provide at least name and phone number, address would be appreciated but not mandatory.
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Provide a reference that is not family member

First Name Last Name
Reference Person's Number

Area Code Phone Number
May we visit your home before and after adoption?

Yes No
What type of dog/cat or specific dog/cat from our adoptable animals are you interested in?
Often times we have multiple applications for the same animal and cannot guarentee a particular one. To help us in finding the best situation for each one, can you tell us why you feel you would be the best home for the dog/Cat you're interested in?
* I / we agree that if we adopt a dog, we will provide professional vet care, a nutritious diet, and a loving home.

*We also agree that we will return the dog if we can no longer keep it.

*No member of our household has ever been convicted of cruelty to animals.
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