Adoption Application

Animal you are interested in adopting

Applicant's First Name *

Applicant's Last Name *

Email Address *

Phone Number *

Street Address *

Apartment Number (if applicable)

City *

State *

Zip Code *

Is your home in an urban, suburban, or rural setting *

What type of home do you live in *

How long have you lived at this address? *

Do you own or rent your home? *

If own, is your home a part of a Condo Association or HOA? *

If renting, please provide landlord's name

If renting, please provide landlord's telephone

Have you owned any companion animals (dogs or cats) in the past 5 years? This includes pets owned by you as well as other members of the household. *

Are there any companion animals (dogs or cats) currently in the home? This includes pets owned by you as well as other members of the household.

If yes, please list the names, breeds, ages of your pets, and dates owned.

Veterinarian's Name

Veterinarian's Phone Number

Veterinarian's Address, City, State, and Zip Code

Please provide the names of 3 personal references along with their contact info and relationship to you *

Why have you chosen to adopt a rescue dog? *

What size of dog are you looking for?

What age are you looking for?

What energy level?

What sex dog are you looking for?

Please explain briefly why you are interested in that dog.

In what timeframe would you be able to welcome a new companion home? *

Including yourself, how many people live in your household? *

Please list the ages & relationship of those who live in your home (including yourself). *

Please describe your lifestyle and the the activity level of 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? *

Does anyone in your household have allergies to dogs/cats? *

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? *

Who will care for the dog when you go on vacation or travel for work? *

Is your yard fenced? *

If yes, what type of fence?

Describe type and frequency of how you plan to exercise your dog *

Describe your experience with basic obedience training, including house, leash, crate training? *

Do you anticipate using a crate with your dog? *

Do you anticipate having to house train your dog? *

Do you have prior experience with certain breeds?

Have you ever experienced behavior or training challenges with a dog? If so, please elaborate on the issue and how you managed it? *

Please elaborate

In the past have you sought out professional dog training or would you be willing to seek and begin professional dog training immediately should challenges arise with a dog? If yes, please elaborate. If no, why not? *

How long do you feel it will take for the dog to adapt to its new home? *

What do you estimate the monthly cost to care for a dog? (food, grooming, vet care, toys, day care/boarding, etc?) *

Have you ever sold, given up, or rehomed a dog? *

If yes, please provide more detail.

If your situation changes, what is your plan for the dog (relocation, divorce, baby, etc.) *

What circumstances would be cause for you to surrender your dog? *

How did you hear about Dog Star Rescue?

Are you a veteran (for DogStar4Vets)?

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. The Dog Star adoption fee 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.

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I certify that my answers are true and complete to the best of my knowledge. I understand that false or misleading information in my application may result in my application being denied.

Applicant's Signature (Submission by email will serve as signature agreement)