Adoption Application
Applicant's First Name
*
Applicant's Last Name
*
Email Address
*
Phone Number
*
Street Address
*
Apartment Number (if applicable)
City
*
State
*
Zip Code
*
Animal you are interested in adopting
Do you own or rent your home?
*
Own
Rent
If renting, please provide landlord's name
If renting, please provide landlord's address
If renting, please provide landlord's telephone
If renting, do you have permission from your Landlord? (documentation of permission required)
*
No
Yes
Have you had other pets, either currently or in the past?
*
No
Yes
If yes, please list the names, breeds, and ages of your pets.
Are these animals still in the household?
No
Yes
If no, please explain...
What size of dog are you looking for?
Small
Medium
Large
Huge
No Preference
What age are you looking for?
Baby
Young
Adult
Senior
No Preference
What energy level?
Low
Medium
High
No Preference
What sex dog are you looking for?
Male
Female
No Preference
Please explain briefly why you are interested in that dog.
Veterinarian's Name
Veterinarian's Phone Number
Veterinarian's Address, City, State, and Zip Code
How long have you lived at this address?
Less than one month
1-2 months
3-6 months
6-9 months
9-12 months
1-2 years
3-5 years
6-10 years
10 + years
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
How often will the dog be in contact with children? (Include family members, visitors, neighbors - provide details)
Who is the dog primarily for?
Adult
Child
Elderly
Does anyone in your household have allergies to dogs/cats?
Yes
No
Possibly
N/A
May we visit your home prior to application approval?
No
Yes
Where will the dog be kept when household members are home? (be specific)
Where will the dog be kept when household members are not home? (be specific)
On average, how many hours per day will your pet be left alone?
Are you required to travel for work?
No
Yes
Who will care for the dog when you go on vacation?
Is your yard fenced?
No
Yes
Will you exercise the dog?
No
Yes
Have you ever crate trained a dog for training purposes?
No
Yes
Do you anticipate using a crate with your dog?
No
Yes
Do you expect to take the dog to formal obedience training?
No
Yes
How long do you feel it will take for the dog to adapt to its new home?
What do you estimate the yearly cost to care for a dog? (food, grooming, vet care, toys, day care/boarding, etc?)
About $100
$100 - $200
$200 - $300
$300 - $500
$500 +
Have you ever sold, given up, or rehomed a dog?
No
Yes
How did you hear about Dog Star Rescue?
Dog Star Website
Facebook
Twitter
Google Search/Attended an Event
Personal Referral/Other
Are you a veteran (for DogStar4Vets)?
Decline to answer
Yes
No
Last chance - tell us anything! Is there anything we forgot to ask? Is there something else you want to mention? Let us know!
General Disclosures: 1. Dog Star adoption fee is $450 (by check or credit card) and covers all vetting costs, including pull fees charged by shelters, spay/neuter costs, vaccinations including bordetella, distemper/parvo, rabies, fecal and heartworm screening, heartworm and flea preventative, interstate health certificate and transportation fees. 2. After filling out the Application, please call your veterinarian to give Dog Star permission to contact your vet. 3. This Application shall be governed by, and construed in accordance with, the laws of the State of Connecticut, irrespective of the laws that might otherwise govern under applicable principles of conflicts of law.
Yes
No
Applicant's Signature (Submission by email will serve as signature agreement)