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, 
             
            
              
                I agree to the terms above. 
                
                  I do not agree 
                  I Agree