Athens Canine Rescue Adoption Application

We work very hard to match our dogs with the right family!

I have read the Adoption procedures

Date Submitting Form:

Name of dog you are interested in:

Applicant Information

First Name:	Last Name:	Age:
Address:	City:	State:	Zip:
Home Phone:	Work Phone:	Cell Phone:
Occupation:	Email:

Co-Applicant Information
First Name:	Last Name:	Age:
Occupation:	Email Address:
Work Phone:	Cell Phone:

Residence Information

Do you live in a (select one):
Do you (select one):
Do you have a fence in yard?
If so, what is the size (type & height)?
If you rent, do you have the landlord's permission to own a dog?
Landlord's Name: Landlord's Phone:
Are there children at this residence?
If yes, list age(s) for each:
Please list all other residents of the home and their ages:

Current Animals - if not applicable, skip to next section

Please list type(s) of animal(s) you currently have or have had in the past 5 years.

Name:
Type of Animal:
Do you still have the animal?
Sex:
Fixed?:
Personality of pet:
Where does pet stay during day?

Name:
Type of Animal:
Do you still have the animal?
Sex:
Fixed?:
Personality of pet:
Where does pet stay during day?

Name:
Type of Animal:
Do you still have the animal?
Sex:
Fixed?:
Personality of pet:
Where does pet stay during day?

Name:
Type of Animal:
Do you still have the animal?
Sex:
Fixed?:
Personality of pet:
Where does pet stay during day?

Name:
Type of Animal:
Do you still have the animal?
Sex:
Fixed?:
Personality of pet:
Where does pet stay during day?

Name:
Type of Animal:
Do you still have the animal?
Sex:
Fixed?:
Personality of pet:
Where does pet stay during day?

If any of the above are dogs or cats, please answer the following questions.

Are they current on all vaccines?
Are they on a tick and flea treatment?
Are they on a heartworm preventative?
Do any of the dogs live primarily outdoors?
Are they allowed on the furniture?
Do you keep an ID tag (other than rabies) on the dogs?
Where do they stay when home alone during the day?
Where do they sleep at night?
Who is your current veterinarian?
Veterinarian Phone Number:

New Dog

Do you have a gender preference?
Do you have an adult weight preference?
Do you have an age preference?
If you adopt a puppy that has not been spayed or neutered, do you agree to have the procedure done?
Does everyone in the household agree to the adoption of a dog?
Who will be responsible for the daily care of the dog?

Please check any of the following reasons for adopting a dog:

Companion
Guard Dog
Hunting
Child's Pet
Gift
Family Member
Other
(if other explain)

Who will be responsible for the obedience training of the dog?
If training with someone other than a professional, has that person successfully trained a dog before?
What skills and/or tricks have you taught your previous dogs?
Approximate amount of time a day spent in play/exercise and type of activity.
If you adopt a dog that has not been housebroken/crate trained, are you able to make the necessary time commitment to train the dog?
How many hours will the dog be home alone on a typical day?
How many hours a day will the dog spend inside the house?
Where will the dog stay when home alone during the day?
Where will the dog sleep at night?
If you are considering a long-haired breed, how often would the dog be groomed?

The dog will eventually become elderly with the possibility of failing health (arthritis, blindness, heart disease, kidney disease, cancer, etc.). Are you able to afford the cost of veterinary care for an elderly dog?

A dog can live for 10-15 years. Can you commit to caring for a dog for that length of time?

What circumstances, in your mind, justify giving a dog up? (select all that may apply)

moving
medical problems
not getting along with other pets
allergies
behavioral problems
housebreaking problems
shedding
children lost interest
too time consuming
new baby
if it gets too big
aggressive behavior
other
(if other, explain)

Have you ever given up a dog?
If yes, explain.
If circumstances forced you to give up a dog, how would you go about doing it?
Have you ever looked at or applied to adopt with Athens Canine Rescue?
If yes, did you adopt?
If yes, who?
If no, why did you not adopt?

How did you hear about Athens Canine Rescue?

Pawtropolis
athenscaninerescue.com
petfinder.com
Flagpole
Critter Magazine
National Animal Information Database [NAIDCharities]
Word of Mouth
Radio
Other
(explain)

Please tell us more about yourself, your family and the type of dog that you are looking for.

Please list 2 different personal references:
First Name Last Name Phone
Relationship with first reference [friend, parent, vet, etc.]
First Name Last Name Phone
Relationship with second reference [friend, parent, vet, etc.]

By typing your full name, and initialing the boxes below, I am attesting to the truthfulness of my answers. Falsification of any of the above information will be grounds for disallowing the adoption of a rescue dog and removal of said dog from my home. Applicant must be at least 18 years of age. Athens Canine Rescue reserves the right to refuse any applicant.

Applicant's Full Name Initials

Co-Applicant's Full Name Initials

If you have not received a reply within 48 hours, please email rescue@athenscaninerescue.com for any questions or comments. Thank you for you interest in adopting a dog through Athens Canine Rescue!