First Name*
Last Name*
Address
City
State/Province
Zip/Postal Code -
Email*
Home Phone
Cell Phone
Which Dog(s) your are interested in : Choose an animal: Bagel Benny Casper Corky Elsie Hope Jax Jessie
Do you have a 2nd Choice? Choose an animal: Bagel Benny Casper Corky Elsie Hope Jax Jessie
If pet is not available are you be interested in another ?
What Age of Pet would you like?
What Size Dog Would you like ? Choose all that apply: Small (1 - 20 lbs) Medium (21 - 45 lbs) Large (46-80 lbs) X Large (81lbs and larger)
Why do you want to adopt this pet ?
Do you Own or Rent your residence?
If you Rent, Please List Name & Phone Number of Landlord :
Do You have a fenced in yard ?
Are you Employed ? Choose one: Yes No
If Yes Name & Phone of Employer
Are you financially able to care for this pet ?
How Active are You?
What kind of activities will you do with your dog?
How long will the pup/dog be alone ?
Where will the animal be kept when you are not home
Name & Age of People in the Home:
Do any of the residents of your home have any medical concerns or allergies to animals?
Have you or anyone living in your home been charged with or convicted of a crime?
Name and Type of Pets in the Home :
Are all pets in your home spayed / neutered ?
If Not, Why ?
Have you ever Turned a Pet into a Shelter ?
If Yes, Why?
Name / Phone of Vet you have used for current or previously owned pets in the last 7 years:
If your pet does not receive vaccinations at the vet office, where do they get them (proof will need to be provided):
Name / Email of Reference 1 (not a Family Member):
Name / Email of Reference 2 (Not a Family Member):
Name / Email of Reference 3 (Not family Member):
Have you applied with any other rescue Choose one: Yes No
How did you hear about us?
I have completed this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand that Red Rock Rescue Inc. reserves the right to annul the adoption and reclaim the animal. If the application passes review, I agree to a home and yard visit on a mutually agreed date by a Red Rock Rescue, Inc. volunteer. I understand the adoption decision is dependent on many factors, including but not limited to the compatibility of the family and home to the individual animal and other applications received on this animal. I understand it is the organization’s prerogative to decide which home is the most appropriate and that the decision is final.
