Dog Adoption Application
If you are having trouble submitting this online form you can click to download a printable application.
Please be sure to fill out all required fields. Once you click submit at the bottom you will receive a confirmation email with a note from our director of operations and the info you submitted. Please email our webmaster if you have any issues with submitting this form.
If you do not receive an email confirmation of your online application - we did not receive the application.
Note: For security purposes we have set a time limit on filling out this form to 45 min. If you receive a message that you "cannot submit the form twice," that means your form has timed out because you have taken more than the allotted 45 minute time to fill it out. Simply refresh the screen and re-submit the form again. |
| First Name (*) |
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| Last Name (*) |
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| Home Street Address (*) |
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| City (*) |
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| State (*) |
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| Zip (*) |
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| E-Mail Address (*) |
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| Cell Phone |
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| Home Phone |
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Personal Information: |
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| How many people reside in your home including you? |
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| What are the ages of the people living in your home? (*) |
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| Do you live in a (*) |
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| If Other, Please Describe |
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| Do you (*) |
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| How many square feet is your home? |
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| If renting, do you have your landlord’s permission to have a pet? |
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| Landlord’s name and phone number |
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| Does anyone in your household have pet allergies? |
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| Would you say your household is |
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| Your Employer |
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| How many hours a week do you work? (*) |
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| Your spouse or roommate’s employer (if applicable) |
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| How many hours a week do they work? |
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| Are you willing to allow us to perform a home inspection before and/or after the adoption process? (*) |
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| If no, why? |
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Your Pet Interests: |
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| How long have you been looking for a dog? |
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| What age of dog are you interested in adopting? |
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| Are you interested in adopting a |
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Are you are interested in a specific |
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| Breed |
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| Size |
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| Color |
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If there is a particular dog you’re interested in, either from the website or from visiting The Pet Rescue Center in person, |
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| Please give us the name |
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| How soon are you ready to adopt? |
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Pet Care Information: |
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| Do you currently have a local veterinarian? (*) |
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| If yes, please provide name and number |
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| May we call your veterinarian for more information? |
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| Who will be responsible for the care of the dog? |
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| What brand of dog food do you plan on feeding the dog? |
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| Do you plan to take any trips or travel in the future? |
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| If yes, what arrangements will you make for the dog? |
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| How do you plan on exercising your dog? |
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| Does your home have a yard that the dog can use for exercise, play, and potty breaks? (*) |
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| If no, where will your dog go to the bathroom? |
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| If yes, please describe your yard. Include approximate size, patios, anything important to owning and caring for a dog |
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| Does your yard have a pool or spa? |
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| If yes, does your pool or spa have a cover or fence that can prevent the dog from falling in when going out into the yard? |
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| If yes, please explain |
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| Does your yard have a fence that encloses it completely? (*) |
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| On average, what is the height of your fence? |
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| How high is the lowest point? |
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| What material is the fence made out of? |
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| Is it in good shape? |
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| Where will the dog be kept during the times you are away from your home for work errands, etc? |
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| On average, how many hours per day do you expect the dog to be left alone? (*) |
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| Where will the dog be when you are at home? |
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| If the dog is kept outside, is there a place that they can go for shelter if it’s raining? |
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| Is there a place with suitable shade during the warm summer months? |
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| Where will the dog sleep at night? |
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| Where will the dog have its food and water? |
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| Do you have a regularly scheduled gardener or pool cleaner that will have access to your yard? |
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| If yes, how will you deal with the situation? |
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| Are there gas or water meters in your yard that meter readers will need access to? |
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| If yes, how will you deal with the situation? |
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Pet History: |
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| Do you currently have any pets? (*) |
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If yes, please list the pets below |
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| Pet 1 |
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| Age |
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| Sex |
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| Spayed or Neutered? |
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| Is this pet comfortable around other pets? |
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| If no, please explain |
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| Pet 2 |
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| Age |
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| Sex |
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| Spayed or Neutered? |
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| Is this pet comfortable around other pets? |
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| If no, please explain |
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| Pet 3 |
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| Age |
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| Sex |
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| Spayed or Neutered? |
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| Is this pet comfortable around other pets? |
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| If no, please explain |
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| Pet 4 |
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| Age |
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| Sex |
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| Spayed or Neutered? |
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| Is this pet comfortable around other pets? |
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| If no, please explain |
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| If you have more pets than listed above, please list them here |
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| If you do not currently have any pets but have had them in the past, please briefly explain what kind of pet and how they died, or why you had to get rid of them, and who you gave them to |
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| Have you previously applied and been approved for pet adoption? |
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| If yes, please list the organizations |
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| Have you ever been turned down for pet adoption? (*) |
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| If yes, please explain |
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| Under what circumstances would you consider getting rid of the dog? |
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| How did you hear about The Pet Rescue Center? |
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| Would you like to be added to our e-mail and/or mailing list? (*) |
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| Mailing Address (if different from front of application) |
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| E-mail (if different from front of application) |
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In Orange County, the average yearly cost of caring for a healthy dog is around $700. This includes routine exams, vaccines, dental care, and emergency care if needed |
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| Are you willing to accept the financial responsibility involved in the care for the dog? (*) |
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| Did you know Pet Insurance can refund up to 80% of your veterinary bills? Do you plan on obtaining Pet Insurance? |
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PLEASE READ BEFORE SIGNING: Submitting this application serves as a request to adopt a rescue from The Pet Rescue Center. I understand that the information that I have provided may be verified by The Pet Rescue Center. I realize that by filling out this application in no way guarantees an adoption with The Pet Rescue Center. |
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| I Read & Agree to the terms above (*) |
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| Enter the image text (*) |
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