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Rescue Dogs Rock, Inc.
Adoption Application for Puppies
If you need to use a phone please make sure you check that there isn't an error message when submitting the form and make sure you receive the confirmation email from us that we've received your application. If you didn't receive a confirmation email, please use our Contact Us page to let us know. Thank you!
Thank you for contacting Rescue Dogs Rock for a new member to your family. We would love to match you with a great rescue puppy.
Please read the below and then answer every question.
To adopt a puppy from Rescue Dogs Rock, please start by filling out our on-line application. We will check all your references, including landlord approval, and if all is well, we will then schedule a home visit. Once you have been notified that you have been approved, arrangements will be made with you to pick up the dog, either from the foster, or from the transport location. The adoption fee is due at the time you are approved for adoption.
The adoption fee for any puppy between the ages of:
* Puppy 5 months and younger $400 per puppy. No exceptions will be made.
* 6 months to 5 years $350
* 6 years and above – $200
All current pets in the home must be spayed/neutered – we do not adopt out to homes with unaltered pets.
You must be at least 23 years old, or if living with parents, have written parental approval.
If you think you want to adopt in the near future, get your application in early – you can be pre-approved for future foster or adoption.
By submitting the below form, you are agreeing that: I understand all of the questions and have completely read the application and understand that this puppy MUST be indoors and this puppy will not be chained/penned outside. I further understand that if for any reason I want to give up this puppy, I will email Rescue Dogs Rock and undergo a 14 day waiting period in which representative from the organization of Rescue Dog Rocks will work with me to resolve any issues with the puppy. I also understand that a representative from the organization may visit the dog to ensure that it is well taken care of; if we find that the dog has been neglected or abused in any way or for any reason, we reserve the right to remove the dog from the premises. Your form submission below authorizes us to do so as necessary, and automatically transfers ownership rights of said puppy back to Rescue Dogs Rock at that time.
Please apply to adopt a dog from Rescue Dogs Rock using the form below:
* Required
Which dog are you interested in?
*
Animal ID #/Petfinder #/Shelter ID # (If not applicable, please mark N/A)
*
Are you interested in adopting?
*
Adopting
Would like approval for the future
If the dog of your choice is not available, would you be interested in adopting another dog? (Please be honest)
*
I would be interested in adopting another dog
I would be interested in proceeding with approval for the future
I would not be interested in adopting another dog
How did you hear about our rescue group?
*
Personal Information
First Name
*
Last Name
*
Full Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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Hawaii
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Texas
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Vermont
Virginia
Washington
West Virginia
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Armed Forces Americas
Armed Forces Europe
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State
ZIP Code
Email Address
*
Your Cell Phone Number
*
Alternate Phone
*
Best time to call
*
Employment
*
Employment of others in the Household
*
Veterinarian Information
(If you currently have a pet, vet information below is required! Also please advise your Vet's office to expect a call from one of our representatives and to release any information requested.)
Your Vet's Name
*
Your Vet's Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Your Vet's Phone Number
*
Personal References. Please provide the name, phone number and email address of TWO personal references we may contact (Neighbor, friend, co-worker).
*
Residence
*
Own Home
Rent Home
Own Apartment
Rent Apartment
Other
Please choose your type of residence.
If you chose other type of residence above. Please explain.
How long have you resided here?
*
If you rent, please provide your landlord's name and phone number
We request this information so that we can verify you are permitted to have a pet.
Please list all people who currently live at this residence (including yourself). (Include name, age, and relationship to you)
*
Who will be responsible for the care of your new dog?
*
Please list all pets who CURRENTLY live in your household. (Include NAME, TYPE/BREED, AGE, GENDER, ALTERATION STATUS, HOW LONG OWNED, INDOOR OR OUTDOOR, CATS DECLAWED.)
*
Please list any pet you have owned in the past. (Include NAME, TYPE/BREED, AGE, HOW LONG OWNED, WHAT HAPPENED TO PET.)
*
Have you ever taken one of your pets to a shelter or given an animal away? Please explain circumstances.
*
Please explain circumstances.
How do you plan to have your dog relieve itself?
*
What type of exercise and activities do you plan to do with your dog?
*
How many hours each day will your new dog be alone?
*
Where will your new dog be kept when you are not home?
*
Where will your new dog be kept when you are home?
*
Where will your new dog sleep?
*
What types of training methods do you plan to use to train your new dog?
*
Many shelter dogs come down with kennel cough. Do you have a way of separating our new dog from your current dogs? If so how?
*
Who will care for your new dog when you are on vacation?
*
Would you like a trainer recommendation?
*
By checking YES you agree that the pup will not be used in any illegal activities nor be found at any time in a municipality where Pit Bull presence is illegal.
*
Yes
No
By checking YES you agree that if you are chosen to adopt the pup, you will review and agree to an adoption contract, which is wholly in the pup's best interests.
*
Yes
No
By checking YES you agree that if you need to relinquish the animal during its life, you will contact Rescue Dogs Rock, Inc for its surrender.
*
Yes
No
By checking YES we have your permission to contact these references.
*
Yes
No
Adoption Terms
By checking YES you agree that all pets in your household are spayed and/or neutered.
*
Yes
No
I have read all the above information carefully and have complete 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 Rescue Dogs Rock reserves the right to annul the adoption and reclaim the animal. If the application passes this review, I agree to a home and yard visit on a mutually agreed date by a Rescue Dog Rocks volunteer or a courtesy visit through another reputable rescue before an adoption decision is made.
In addition, 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 their decision is final.
Signature
*
Today's Date
*
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