First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone*

Cell Phone*

Alt Email

Applicant Full Name:*

Applicant Age:*

List the full names, ages and relationship to you of ALL residents in the household:*

Animal Name:*

Why are you interested in adopting an animal at this time?*

The following best describes your home atmosphere:*
Choose one: Active with lots of visitors Some activity Quiet and serene

How would you describe your dog experience?*
Choose one: This will be my first dog I've had 1 or 2 dogs I'm experienced and knowledgeable

Describe what type of dog you are looking for (age, size, activity level):*

Have you applied with any other rescue?*
Choose one: Yes No

If yes, what rescues and what is the status of your application? If no, state N/A.*

How did you hear about us?*

Where will the animal be kept when you are home?*

Where will the animal be kept when you are not home?*

Where will the animal sleep?*

How many times will you walk the animal per day?*

How do you plan to potty train the animal?*

Describe how you will train the animal:*

Describe how you would handle if the animal starts digging, barking excessively, chewing, showing aggression or other similar issues:*

Do you have a yard?*
Choose one: Yes No

If yes, what type of fence and how high? If no, state N/A.*

In what type of home do you live?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you have a Homeowners Association or Condo Owners Association?

If yes, what is the Association name and phone number? If no, state N/A.*

Do you rent or own your home?*
Choose one: Rent Own

If you rent, have you received the approval of your landlord to have an animal? If you own your home, state yes.*
Choose one: Yes No

If you rent, please enter your landlord's name and phone number. If no, state N/A.*

Are there any pet restrictions? (Check All That Apply)

Do you currently have any animals?

If yes, what are their names, breeds, ages and how long have you had them? Are they spayed/neutered and up to date on vaccinations/HW prevention? Please include ALL PETS in the household. If no, state N/A.*

If yes, how is your pet around other animals? What is their playstyle? (rough, gentle, loves to chase/be chased, or not playful) If no, state N/A. *

What is the name and phone number of the veterinary office you have used within the past 3 years? If none, state N/A. *

If you have had animals in the past, what kind and what happened to them?*

Have you ever given up an animal? If yes, please explain why. If no, state N/A.*

What is your occupation?*

How long have you been at your current employment?*

List at least two references, who are not family members (name and phone number): *

In case of a temporary emergency, who would care for the animal?*

I hereby certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me from adopting an animal. Type name and date.*

You will be asked to sign this agreement at the time your application has been approved and you decide to adopt an Everglades Angels dog. PLEASE READ CAREFULLY Adopting a pet is a serious and long term commitment. A pet you adopt today will likely be a part of your family for the next 10 to 15 years! Each pet has its own personality and preferences that you can help shape through love and conscientious training. A dog makes considerable demands on your time and resources. Dog parents need to spend time walking, grooming, training, and playing with their dogs every day. Some dogs may require professional grooming, training, and special food. Regular veterinary care is required, including annual vaccinations and MONTHLY PREVENTIVE MEDICATIONS FOR HEARTWORM AND FLEAS AND TICKS! Even in the case of healthy animals, these expenses can exceed $1,500 a year. *If you are adopting a PUPPY, please be aware that they may not be finished with the required puppy shots. It is the adopter's responsibility to ensure that your puppy receives the required additional vaccinations. *EVERGLADES ANGELS DOG RESCUE™ has the right to request proof of required additional puppy vaccinations. I agree to care for the animal in a humane manner and be a responsible animal guardian. This includes supplying adequate food, water, shelter, attention, and medical care. A representative from EVERGLADES ANGELS DOG RESCUE™ will follow up with you and your pet by visiting you in your home or by talking with you over the phone. We would visit your residence by appointment only. I agree that if at any point I cannot keep the animal, I will return him/her to EVERGLADES ANGELS DOG RESCUE™. I understand that EVERGLADES ANGELS DOG RESCUE™ has the right to deny any application. This is a legally binding contract. I agree that all statements I have made on this application are true. If it is found that any statements I have made on this application are not true, the adopted animal will be confiscated and brought back into the Loving Care of EVERGLADES ANGELS DOG RESCUE™. All Household Residents must be in Total Agreement of the Adoption. All persons residing in the residence above the age of 18 must sign and date. If you agree with the above statements, type your name and date.