First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Availability

Can this number send/receive texts?

Date of Birth (ex: 01/01/2021)*

Driver's License (ex: RI 8675309)*

Residence*

Details, if any

Landlord's name, if applicable (first/last). **If you do not own your home, you must provide landlord information.**

Landlord's phone #, if applicable. **If you do not own your home, you must provide landlord information.**

Select your requested animal if looking for a specific pet
Choose an animal: Bailey Robinson Bella Provac Boone Robinson Boozer Henson Carter Provac Cavonia Henson Charley Oliver Skip Provac Clyde Henson Local Cody Johnson Wallace Dixen Henson Doby Dean Gabby Robinson Harvey Henson Irie Provac Jackson Henson Ken Local Monkey Dean Oliver Local Pixie Henson Porter Provac Prudence Newberry Rain Kitty Local Remi Local Rocco Provac Roma Local Roscoe Newberry Rubi Provac Sadie Provac Sally Henson Sugar Cookie Parl Local Tobias Henson Zuko Local

If not interested in a specific animal, what type(s) of animal are you interested in?

Have you owned dogs or cats before?*

Do you currently own pets?*

If you own pets, what can you tell us about them?

If you currently own pets, where are the usually kept?

If you currently own pets, are they up-to-date on their vaccinations?

If you currently own pets, are they spayed / neutered?

If approved, how many hours a day will your animal(s) be alone?*

If approved, where will your animal(s) be kept while you're not at home?

If approved, the animal(s) will need to get along with:

Please list the full names and dates of birth of anyone living in home.*

If you have a current veterinarian, what is their name? (first/last)

If you have a current veterinarian, what is their phone #?

Please check any boxes you'd like to discuss with us:

Is there any additional info you want to disclose or discuss?

How did you hear about Rhode Home Rescue?

I understand that I must complete this adoption application AND receive approval from RHR for said adoption.*

I agree to pay the full adoption fee in the event that I am granted adoption privileges. IF fostering, I understand that discounts are not provided to fosters or to any foster animal(s) in my care.*

I understand that it is my responsibility to return a borrowed RHR crate and any other unused supplies or equipment (if applicable) to RHR upon completion of adoption contract.*

In applying to adopt this Rhode Home Rescue animal, I agree to the additional terms, conditions and policies established by RHR. (1)To provide food, water, shelter and humane treatment for this animal at all times. (2)To provide annual vaccinations and medically necessary veterinary care as directed by your vet. (3)To take this animal to the vet within 2 weeks of adoption and alert RHR of appointment date via email. (4)If a dog, to prevent this dog from running at large. Dogs must be on a leash or kept in an enclosed area. (5)To submit to an investigation should it be determined that the conditions of this contract are not being complied with. (6)To receive approval from RHR before surrendering the animal to another organization or home. RHR retains the right to have the animal returned to RHR.*

I expressly understand that RHR, its directors, volunteers, or coordinators have made no warranty or representation regarding any particular temperament, behavior, or tendencies of any animal that I may choose to take into my possession (either temporary or permanent). In general the animals that are placed for permanent adoption or temporary foster by RHR have been abandoned by their owners, neglected to some degree, or placed in shelters. Their behavior to different settings and reaction to different stimuli cannot always be predicted or anticipated. I hereby indemnify and hold RHR harmless, along with each of its directors, coordinators, and volunteers, from any liability or consequential damage(s) caused by any action or reaction of any animal in my care.*

By selecting "I AGREE" below and submitting this form, you certify that your answers on this application are true and complete to the best of your knowledge. You also grant your permission and consent for us to contact the necessary resources and references to verify your responses on this application.*

Type your full name. By typing your name below, you agree to consider and accept it as if it were a signature. This is enforceable considering we maintain forensic metadata at the time of submission, including but not limited to, timestamps, email address, and IP address of the applicant.*