Extra Mile Dog Rescue

Adoption Application

Extra Mile Dog Rescue
Adoption Application

You will be contacted by email or phone as soon as your submitted application is reviewed. 

Date:
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Home Phone:
Alternate Phone:
Email:
How many children live in your home and what are their ages?
How many adults live in your home?
Do children frequently visit your home? If yes, what ages?
Is anyone in your home nervous about pets?
I currently:
My home is in the:
Please list all pets in your household, specifying species/breed/age:
Are your current pets spayed/neutered?
Do they live indoors or outdoors?
Have you had other animals in the last five years?
If yes, where are they now?
Do you currently have a veterinarian?
If yes, who?
Are you planning to take your dog to obedience classes?
Are you prepared to spend $300 to $500 a year on basic expenses (food/medical)?
Will your dog be kept primarily:
How many hours will your dog be left alone each day?
Where will your dog be left alone?
Where will your dog sleep at night?
 I have a: Fenced yardInvisible fenceOutside kennelStationary tie-outUnfenced acreageWill leash walk daily
I am looking for a:
What energy level are you looking for in your pet?
At it's adult size, my ideal dog would be:
Check all reasons for adopting a dog: Companion for selfChild's petCompanion for other animalGift for someoneHuntingWatch dog/protectionOther
Qualities I want in my adopted dog: Already house trainedAlready knows basic commandsDoesn't pull on the leashCan be left in the house unattendedCan be walked off leashDoesn't jump upRarely barksDoesn't digLow sheddingDoesn't chewLikes to play/fetchDoesn't wanderWill jog or run with meGentle with young childrenGood watch dogGood with strangersLikes other dogsGood with catsGood with livestockOther
Under what circumstances would you give up this dog? Bites/aggressiveDifficult to house trainChews/destructive when left aloneRequires too much exerciseWandersMoving to "no pets allowed" housingMoving out of stateMedical expenses/animal is illAggressive with other petsOther
How did you learn about the Extra Mile Dog Rescue?
Do you agree to allow a representative of the Extra Mile Dog Rescue to visit your home prior to adoption?
What Extra Mile dog are you interested in adopting?

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