Take 2 Rescue | Online Adoption Application

Take 2 Rescue Online Adoption Application
Tell Us About You!
Full Name :
Date of Birth :
Spouse/Other Adult Full Name :
Address :
City :
State :
Zip Code :
Home Phone Number :
Cell/Alternate Phone Number :
Email Address :
Employer :
Length of Employment :
Type of Housing :
Own Or Rent :
Length of Time at Current Home :
For Renters.................................................................
Landlord Name :
Landlord Phone Number :
....................................................................................

Tell Us About Your Household!
Number of adults :
Number of children :
Ages of children :
Do the children live with you full time?
How often do other children visit?
Describe your lifestyle. Is it active (hiking, camping, community work, in our out a lot), or more relaxed and structured? :
Is anyone in the home allergic to animals?

Tell Us What You Expect from This Pet!
Which pet are you applying for?
Who will be the primary caretaker of your new pet?
Why do you want a dog?
Why this breed?
What characteristics are you looking for in a dog?
What characteristics would you find undesireable?
Would you be willing to take an obediance class to correct problems?
What problems would make you return the dog?	Housebreaking Barking Chewing Jumping Up Gets too big Shyness/Fear Aggressive Shedding Digging Getting out of fence Not getting along with other pets Not getting along with children Scratching/Climing on Furniture Behavior problems Medical problems Other (explain below)
What changes in your life would make you return the dog?	Moving Marriage Separation/Divorce Having Children Allergies Loss of Job Increased work hours Medical problems Death of Family Member Other (explain below)

Tell Us What a New Pet Should Expect from You!
Would the dog be housed inside or outside/loose or crated, etc?
Is your yard fenced?
If yes, please describe the fence.
If no, how will you teach the dog to relieve itself?
Where will the dog stay when you are not at home?
How many hours per day would the dog be alone?
Where would the pet sleep?
Describe how you would exercise the dog.

Tell Us About Your Other Pets!
List breeds/ages/sexes of current pets.
Are current pets spayed/neutered, current on vaccinations & on heartworm preventative?
Date of last heartworm test :
Type of heartworm preventative used :
Veterinarian :
Vet's phone number :
List previously owned pets and what happened to them :
Have you ever given a pet up? If yes, please explain the circumstance.
Have you ever applied to a rescue?
Which ones?
Approved or Denied :
Local Dog Warden/Animal Control Officer (if unknown, type unknown) :
Dog Warden/Animal Control Officer Phone Number:
Groomer (if none, type none) :
Groomer Phone Number :

Tell Us About Your Other Interests!
Willing to adopt an older pet :
Willing to adopt a special needs pet :
Interested in fostering :
If yes, short-term, long-term, or both :
Agree to home visit :

How did you find out about Take 2 Rescue?