Applicant's First Name
Applicant's Last Name
Apartment Number (if applicable)
Do you own or rent your home?
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)
Have you had other pets, either currently or in the past?
If yes, please list the names, breeds, and ages of your pets.
Are these animals still in the household?
If no, please explain...
What size of dog are you looking for?
What age are you looking for?
What energy level?
What sex dog are you looking for?
If you are interested in a specific dog, please list their name and briefly explain why you are interested in that dog.
Veterinarian's Phone Number
Veterinarian's Address, City, State, and Zip Code
How long have you lived at this address?
Less than one month
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)
Does anyone in your household have allergies to dogs/cats?
May we visit your home prior to application approval?
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?
Who will care for the dog when you go on vacation?
Is your yard fenced?
Will you exercise the dog?
Have you ever crate trained a dog for training purposes?
Do you anticipate using a crate with your dog?
Do you expect to take the dog to formal obedience training?
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?)
$100 - $200
$200 - $300
$300 - $500
Have you ever sold, given up, or rehomed a dog?
How did you hear about Dog Star Rescue?
Dog Star Website
Google Search/Attended an Event
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.
Applicant's Signature (Submission by email will serve as signature agreement)