Date
Name of the dog you are interested in adopting
Full Name
Occupation
Phone
Phone
Email
Street Address
Apt/Suite
City
State
Zip Code
Driver's License Number
State
Date of Birth
Name of Partner
Partner's Occupation
Partner's Phone
Names and ages of children, if any
Any other persons living in your home
List and describe regular visitors to your home (human and animal)
Name, address, and phone of your vet
List two personal references, name, address, phone
Have you applied to adopt a dog through another rescue group? If so, who?
Have you ever been refused an animal adoption?
Specify other:
If renting, do you have your landlord’s written permission and is it allowed in your lease to have a dog?
Landlord's Name
Phone
If yes, explain restriction
Contact's Name
Phone
HOA Name
How many stairs do you have?
How far do you live from a busy street?
LIFESTYLE Will the dog’s main living area be inside or outside?
On an average day how many hours will the foster dog be left alone?
Crate dimension
Contained to what room(s) if any?
What areas outside are available to the foster dog? Yard
Chain link fence height
Wood fence height
Block wall height
How many gates? Height?
Kennel Dimensions
Enclosed Patio
Garage
Balcony
Dog house
If you are not fenced, how do you plan to potty and exercise your dog?
Where will the dog spend the night?
What would happen to the dog if you have to move locally, out of state or even out of the county?
If you have children, describe their previous experience with dogs
Below list the dogs you have now or have owned in the last ten years and explain what happened to each of them (Name, Breed, Age, Sex F/M, Spay/Neutered, Length of ownership, What happened)
Do you have any cat? If so, how are they with dogs?
Do you own any other animals?
How many litters?
Have you ever given a pet away? If yes, why and where did your pet go?
How would you discipline your dog for misbehaving, give examples
Who will be the dog’s main caregiver (grooming, feeding, and exercise) and their age/s?
PLEASE READ AND INITIAL EACH STATEMENT BELOW: The rescue reserves the right to refuse adoption to any applicant for any reason. This application and agreement becomes part of our contract. Initial
I understand that a home visit is REQUIRED prior to final placement. Initial
I understand that a home visit DOES NOT guarantee placement. Initial
Walking dogs off leash will put the dog in unnecessary danger. I understand that my dog must be under my control at all times, and will abide by local and state ordinances regarding leash laws. Initial
If you adopt a dog from Useless Bay Sanctuary, and your dog goes missing for any reason, you agree to contact Useless Bay Sanctuary immediately so we can help recover the dog quickly. Dog owners can take simple measures to prevent losing a dog and to facilitate a speedy recovery if a dog is lost (described in a separate document). I agree to read these tips and implement them to the best of my ability. Initial
If for ANY REASON, I am no longer able to provide a home to the dog adopted through Useless Bay Sanctuary, I shall immediately notify them of the situation and, with their approval, either place the dog in a home approved by Useless Bay Sanctuary or return the dog to the possession Useless Bay Sanctuary. Initial
I understand that any monetary donation/contribution is a gift given freely, not a purchase price of dog. Initial
Useless Bay Sanctuary asks for a minimum donation of $300. Initial
I would like to make an additional donation (please specify amount below) to help rescue, provide medical care, spay and neuter, board and place other abandoned dogs. Initial
All the information I have given above is true and complete. Useless Bay Sanctuary has my/our permission to contact individuals and/or businesses I have listed in the above responses. Should an unspayed or unneutered dog be placed with me, I agree to have it spayed or neutered within one (1) month of adoption or by a date agreed upon by me and Useless Bay Sanctuary. This dog will reside in my home as a pet. It is solely my responsibility to provide adequate food, water, shelter, training, affection, safety and medical care. I understand that Useless Bay Sanctuary is a rescue/referral service and is not responsible for the accuracy of information received about temperament, habits, or physical condition of the dogs available for adoption. I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adopt it. I am in full agreement with these terms of adoption. Useless Bay Sanctuary is in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog into my household and I/we agree to indemnify and hold harmless Useless Bay Sanctuary and its’ officers, members, and/or agents from any claims for damages arising from actions of a dog adopted by me/us. I/we also understand that my/our dog will be micro chipped prior to adoption and that Useless Bay Sanctuary shall remain as “alternate contact” through the micro chipping service. I agree to allow a UBS representative to examine the dog and his/her living conditions, at any time if they have a reasonable belief that the dog is not being cared for in a proper manner. If the dog’s living conditions are deemed unacceptable or if I have violated the Adoption Contract in any way, I agree to immediately surrender the dog to a UBS representative.
ACCEPT
SUBMIT