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Every Dog’s Dream rescue would appreciate your taking the time to accurately fill out this application. Please realize that we ask this information to assist us in matching you with the right dog. We will review your application and call your veterinary to verify the information you have provided. Once we have completed that step, we would ask that you allow us into your home for a visit and bring the dog with us that you are inquiring about. This allows you the chance to see him/her before making your commitment. We reserve the right to refuse any applicant for any reason. Applications are not “first-come, first-served.” Adoptions are based on the best home for each pet and the best pet for your household.

Dog(s) name that you are inquiring about:

Name and Complete Address:

Home Phone # (include area code): Cell # (include area code):

E-mail Address: What year were you born?

Do you own or rent __________________

Do you live in: ____City House ____Country Home ____Townhouse ____Mobile/Trailer

How long have lived at this address? Will you be moving soon?

If moving, Where?

Your Occupation: Spouse's Occupation:

How many adults living in your home? How many children living at home? Ages of children

Does anyone in your home have allergies?

Where will the dog be kept during the day? At Night:

Will the dog have the run of the house? Number of hours the dog will be left alone:

How will you safeguard your new dog while you are away from home? ___ Crate ____ Blocked off in room or other ____ Other (please explain if other)

Who will care for your dog when you go on vacation or have an emergency?

Is your yard fenced adequately to keep your dog in and other dogs out?

What type of fence? (Picket, Chain, Stockade) How tall is the fence?

If you do not have adequate fencing how will you exercise the dog?

Who will supervise these activities?

Will your dog be left alone outside for any amount of time when away from home?

Have you lost a pet due to illness old age accident ?

If a pet has been accidentally hurt or killed, please explain how.

Please list your any animals you owned and how long they lived:

Have you ever had to give up a pet? If yes, why ?

Have you ever brought an animal to the shelter? If yes, why?

What lengths would you go for to search for your pet if it were to get lost?

If your pet has or develops behavior issues (i.e - urinating in inappropriate places, chewing, clawing, excessive barking, etc...),are you prepared to handle this? ______________

In your opinion, what would justify returning an animal?

If something life changing should happen to you making the pet an obstacle or inconvenience to you (i.e.- move, divorce, kids leave home, lose job, illness, death etc.), what would you do?

Please List Pets that you have owned

Pets name: Breed: Age :

How long owned? Male or Female? Are they neutered/spayed?

Are they up to date on their annual vaccinations?

Pets name: Breed: Age :

How long owned? Male or Female? Are they neutered/spayed?

Are they up to date on their annual vaccinations?


For Your Application to be Considered, Please provide the following information and notify your vet that we will be calling to check your history:

Vet: Phone Number: Acct Name:

Are you willing to:

1. Provide heartworm preventatives, monthly flea/tick protection, annual veterinary exams and vaccination?

2. Use a crate (optional)?

3. Take time to work with a dog?

4. Have dog spayed/neutered if not already done (mandatory)

5. Walk dog on a leash?

6. Go to obedience training (optional)?

7. Housebreak the dog?

Our policy states you must contact us and return the dog to us if for any reason you cannot keep it. Will you comply with our Policy?

It may take new dogs several weeks to adjust to a new family and a new home. Are you willing and prepared to allow this much time for him/her to adjust?

The above information is correct to the best of my knowledge which I hereby certify with my (our) signature(s)

Name Date

Reasons your application would be denied:

1. We prefer no renters. 2. If you live near a busy road or within city limits, a fenced in area is required. 3. Our dogs are inside dogs, they are not to be tied out to dog houses. 4. If you have small children under the age of 7 we might decline your application. If they have been around dogs before, this will be taken into consideration. 5. Unaltered dogs 6. If you are under the age of 21. 7. If you do not have a job to support your adopted dog 8. You live more than 1 1/2 hours away 9. You are a college student.

Audrey Woerter/Every Dog’s Dream Rescue.
1270 State Highway 206
Greene NY 13778.
Freephone:+1 ###-###-####
Telephone:+1 607-242-2346
FAX:+1 ###-###-####
E-mail: [email protected]

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