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ALL QUESTIONS MUST BE ANSWERED IN ORDER FOR YOUR APPLICATION TO BE PROCESSED
(use the tab key to move from field to field). Please save this document to your computer before
completing. When finished, attach the saved file & email to [email protected]
(Note: You must be at least 18 years old in order to adopt a pet from Tess K9 Rescue. Also please only the actual applicant
should fill out this application as the answers need to come from the person actually adopting the dog. )
Name of Pet you are interested in:__________________________
Date: Your Email Address:
(Include names of all adults in family who will be adopting; i.e. spouse or significant other, if applicable)
Your Name:
Name of Spouse:
Address: City: State: Zip:
Home Phone: Work Phone: Cell Phone:
Age of Applicant: Age of Applicants Spouse (if applicable):
Occupation of Applicant: Place of Employment Of Applicant:
Occupation of Spouse: Place of Employment Of Spouse:
How did you hear about Tess K9 Rescue?
Our average adoption fees are $150.00 to $500 and it includes current shots, microchipping and spaying or neutering if
the dog is over 7 months of age. (Depending on the dog the adoption fee will vary a small amount according to age,
breed and medical expenses.)
*** Please keep in mind that most of our puppies are spayed/neutered at 6 months of age and adults are spayed/
neutered as soon as appointments allow.
***Please understand that if the dog you are adopting from us has been microchipped, we
must remain as point of contact on that microchip and this will be reflected on the
registration. We will be responsible for registering the microchip online at no extra cost to
you and for making any updates that may be needed as you provide us with them.
VERY IMPORTANT: Do you agree that if you adopt a puppy that is not spayed or neutered you are
responsible to spay or neuter your pup before the age of 6 months?
***Please understand that failure to complete the spay or neuter will void the adoption contract.
Pet History (please list current and previous pets, use additional sheet if necessary)
Name
Breed
Age
Gender
Altered?
Current on Vaccines
How long have you had this pet and what happened to him/her?
Pet 2
Name
Breed
Age
Gender
Altered?
Current on Vaccines
How long have you had this pet and what happened to him/her
Pet 3
Name
Breed
Age
Gender
Altered?
Current on Vaccines
How long have you had this pet and what happened to him/her
1) What is the name of your veterinarian?
2) What is your vets phone number?
3) Vets address (street, city, state)?
4) If you do not have a current vet, what vet will you use if you choose to adopt a dog
from us? Please give name and phone number.
5) Are you currently looking at other dogs to adopt as well as one of ours?
6) Do you understand that your new pet will need monthly heartworm prevention and
yearly vaccinations/check-ups to remain healthy? Yes ☐ No ☐
7) Do you agree to provide said vet care to your adopted pet? Yes ☐ No ☐
8) Have you ever adopted a dog from a rescue/shelter before? Yes ☐ No ☐ *** If so,
appx. how long ago?
9) If so, what type of pet was adopted and which agency did you adopt from?(please give
name and phone number if possible)
10) How many adults live in your household? *** What hours are they at home?
11) Have all the adults in your household agreed to this adoption? Yes ☐ No ☐
12) How many children are in your household? *** What are their ages?
13) Do you have children/grandchildren that will be visiting the dog on a regular basis?
Yes ☐ No ☐
If so, what are their ages?
14) Do you want an inside dog or an outside dog?
15) What hours will the dog stay alone?
16) Where will the dog stay when no one is home?
17) Where will the dog stay during the day? *** During the night?
18) Where will the dog stay and who will provide for him if you are away?
a) Do you travel for business? Yes ☐ No ☐
b) Do you travel for vacation? Yes ☐ No ☐
19) Will the dog be left outside unattended at any time? If yes, explain.
20) Describe the area where you live (city, suburban, rural)
21) Do you own your own home or rent? Own ☐ Rent ☐ (Note: Your name must be on
the mortgage/lease in order to adopt)
***Do you live in an apartment, a house, a townhouse, or on a military base?
22) Do you have any plans of moving in the future?
***If you have to move what will you do with your adopted dog?
23) If you rent, do you have written permission from your landlord to adopt a dog? Yes ☐
No ☐
***What is your Landlord’s name and telephone number for verification:
24) Do you have a fenced in yard? Yes ☐ No ☐ How high is your fence at the lowest part?
25)Describe your fencing and gates: (type of material and height):
***If suggested, do you agree to buy a crate for your adopted dog?
26) If you do not have a fenced yard, what arrangements will you make to attend to your dogs exercise and toilet needs?
27) If the pet you are interested in adopting is not yet housebroken, are you prepared to house train him/her?
If so, what method of house training do you plan to use?
28) During the adoption process, would you allow a Rescue representative to visit your home? Yes ☐ No
29) After the pet is placed, would you allow a Rescue representative to make a follow up visit to your home? Yes ☐ No
30) Are you looking for a puppy or an adult dog?
31) If adopting a puppy, are you prepared to handle the chewing stages that a puppy goes through during their first year of life?
32) Are you aware that some dogs can live up to 15 years or more and are you prepared to commit to caring for this dog for his or her entire lifetime?
33) Under what circumstances would you find it necessary to surrender your dog? Moving ☐ Marriage ☐ New ☐ Baby ☐ Divorce ☐ Schedule Change ☐ Illness ☐ Behavioral problems such as jumping, chewing, crying, etc. □ Other (please explain your answer)
34) Do you agree to notify us and to return your adopted pet to Tess’ K9 Rescue if you cannot keep it? Yes ☐ No ☐
(As part of our legal binding adoption agreement, you must return your adopted pet to Tess’ K9 Rescue, if, at any time, you no longer want or are able to care for it - adoption fees are non-refundable)
35) What approximate weight range do you expect your dog to be when
grown?
36) *** Answer only if you are adopting a Bully Breed: What are your neighborhood policies on them?
37) ***Answer only if you are adopting a Bully Breed: Why do you want to adopt a Bully Breed dog?
38) What behavioral issues can you not tolerate?
39) What would you do if the dog displays bad behavior?
40) What steps would you be willing to take to help your dog correct this behavior?
41) What restrictions would you place on your dog’s interactions with children?
42) What restrictions would you place on a child’s interactions with your dog?
43) Are you familiar with your citys animal ordinances?
Licensing? Vaccinations? Leash Laws?
44) There are times when unexpected and often very expensive medical needs arise. Are you committed to providing whatever medical care your vet deems necessary for your dog?
45) Do you consider yourself to be financially stable enough to provide a good home, proper diet, annual check-ups and vaccinations, HW and flea prevention and emergency medical needs as needed?
46) What qualities are you looking for in a dog?
47) Why did you choose this dog?
48) Please tell us any other information about yourself that you would like to share. This helps us in matching our dogs to their new owners.
We want to thank you for taking the time to fill out this application. You have taken the first step in adopting a lifelong companion. These wonderful, loving puppies and dogs need a home and a family, the confidence that comes with having someone love them, someone to call their own, a sense of belonging somewhere and the security of knowing they will never have to be homeless and hungry again.
Thank you for considering adopting a rescued dog. When you adopt a rescued dog you help save two lives, the one you adopted and the next one you just made room for in the Shelter.
We will be in touch with you soon.
Tess K9 Rescue
Saving lives one dog at a time
49) Does anyone in your family have any allergies?(Please explain who and to what)
50) Please provide the names, addresses and telephone numbers of three personal references (two must be nonfamily members please specify relationship with references):
1)
Name:
Address:
City, State, ZIP
Phone Number:
2)
Name:
Address:
City, State, ZIP
Phone Number:
3)
Name:
Address:
City, State, ZIP
Phone Number:
Signature:________________________________ Date:_________________________
