Full Name
Age
Street Address
City
State
Zip
Email
Home Phone
Cell Phone
When is the best time to reach you?
Family Information
Living Status
I Live Alone
I Live With Others
If you live with others, do they approve of you bringing this dog into the home?
Yes
No
Does your spouse/significant other approve of you adopting this dog?
Yes
No
Name of spouse/significant other
Age of spouse/significant other
Do you have children visit your home regularly or living in your home?
Yes
No
If so, how many children?
What are their ages?
Please list others in your household who will have contact with the dog; such as a nanny, maid, etc. If there is nobody else, the please specify.
Accomodations
Why do you want to adopt a rescued dog?
What qualities do you like in a rescued dog?
What qualities or traits don’t you want to find in a rescued dog?
Are you committed to caring for this dog for its lifetime?
Yes
No
Where will the dog stay during the day?
How many hours per day are you out of the house? Do you work full time, work from home, retired, or stay at home?.
Will the dog have access to the house AND yard while left alone?
Yes
No
Who will let the dog out?
Do you have a dog sitter?
Yes
No
Do you have a dog walker?
Yes
No
Do you have a dog door?
Yes
No
Where will the dog sleep?
Will the dog be allowed in the furniture?
Yes
No
Do you own your own home or rent?
Own
Rent
Does the landlord approve of dogs on the property?
Yes
No
Please give the name and number of your landlord as they will be contacted to verify that you are allowed to have animals.
Please attach a copy of your lease or notarized statement from your landlord stating the number and size of pets you are allowed to have on the property.
Please explain what kind of home you have. ie house, apartment, condo, etc.
Do you have a fenced-in yard?
Yes
No
Please explain what kind of fence you have. ie chain link, picket, etc.
What is the height of the fence?
How are you going to exercise this dog?
How are you going to keep this dog from running away or becoming lost?
Rescue Dog Information
Please note - The Dexter Foundation rarely has puppies. But please tell us your preferences.
Are you interested in a specific Dexter Foundation dog(s) listed on our homepage or petfinder.com page?
Yes
No
Which are you interested in?
Male
Female
No Preference
What age are you interested in?
Older Dog
Middle-aged Dog
Younger Dog
No Age Preference
Would you adopt two dogs that have come from the same home & need to stay together?
Yes
No
Does the dog need to be cat-friendly?
Yes
No
Doesn't Matter
Does the dog need to be dog-friendly?
Yes
No
Doesn't Matter
Previous Pet History
Have you ever owned a dog before?
Yes
No
Tell us about your previously owned dogs. List the breed, and the number of years they were with you.
Do you have any in your home currently?
Yes
No
Please list their breed, age, and sex.
Are they spayed/neutered
Yes
No
Please explain why they're not spayed/neutered.
Are all your current pets up to date on their annual vaccinations?
Yes
No
In addition to the pets identified above, what other pets have you owned int he last five years?
Have you owned any other pets more than five years ago?
Yes
No
Please describe how long ago you owned these pets, and describe the animals.
Why do you no longer have these pets?
Do you have any experience with formal obedience training of dogs?
Yes
No
Please explain the methodds of training and where you learned how to train a dog.
Have you filled out an adoption application with any other rescue organization?
Yes
No
To whom did you apply, and when?
Have you adopted a dog from a rescue organization in the past?
Yes
No
From whom and when did you adopt? Please list their name and contact number if applicable.
How did you hear about The Dexter Foundation?
My Vetrinarian
American Kennel Club
Internet
Friend
Other
If you selected Other above, how did you hear about us?
References
We would like to contact two personal references. Please provide their name and phone number
First Reference
Name
Phone
Second Reference
Name
Phone
Release for Veterinary Reference
My current veterinarian's name
My current veterinarian's address
My current veterinarian's phone number
If you do not currently have a veterinarian, please provide us details about who you plan to use.
Planned Veterinarian's Name
Planned Veterinarian's Address
Planned Veterinarian's Phone
I, , hereby give permission for any veterinarian providing service to me/my animals to release medical information on any/all of my animals to the Dexter Foundation, Inc.
This release is not limited to the veterinarian named above. Please let your vet know we will be calling for a vet reference.
I agree to the terms above.
I do not agree
I Agree