LAST HOPE DOBERMAN RESCUE

     Adoption/Foster Application...                                                              please print out...fill out and sign....scan and email it to francinecase@windstream.net                                                            

 

Doberman Rescue

ADOPTION or FOSTER APPLICATION

                                                                                               

All potential adopters and foster homes are screened for suitable placement of animals. We reserve the right to refuse placement of an animal for any reason.

REQUIREMENTS/QUALIFICATIONS:

*You must be 21 years of age or older and have identification showing your present address.

*You must have the consent of all adults living in the household.

*You must have the consent of your landlord if you rent your residence and proof of pet deposit.

*Your pets must have current vaccinations and be free of contagious illnesses and be spayed or neutered.

*You must be able and willing to spend the time necessary to provide/administer proper training, medical treatment, and care for the pet.

*You must agree that any damage done to your home by the pet is NOT our responsibility.

*Adoptions are restricted to families with children ages 7yr and older and are considered on a “case by case” basis.

 

ADOPTION / FOSTER INFORMATION

 

NAME_________________________________________________HOME PHONE#_____________

 

ADDRESS_________________________________APT#____________________

 

        City/State   _______________________ZIP________EMAIL______________________

                                                                                                                               

         Cell Phone # ___________________________    WORK PHONE #_______________

 

Please Circle:    Own home         Rent      Live w/parents             Military

                           House     Apartment     Condo     Townhouse    Duplex     Mobile Home

 

EMPLOYER______________________________________________________________________

 

EMPLOYER ADDRESS _____________________________________________________________

 

This pet will be kept:

                Totally Inside                        Mostly Inside                        Most Outside                        Totally Outside

 

Number of adults in household: _____Number of children in household: ____Ages______________

 

Do all adults in household consent to adoption of this pet      Yes/No

 

Are you a student?   Full-time/part-time                          Do you travel frequently?       Yes/No

 

Does anyone living in your household have any known allergies to:

                Cats    Yes/No                      Dogs    Yes/No                     Other animals?     Yes/No

 

Do you have an enclosed fenced yard attached to your home?    Yes/No           Type of fence:  Wood/chain link/Other   Height :_______ft.

 

Is your fenced large   Large?  Medium?  Small? (circle one)

 

How long at current address? _________yrs  ________ mos.

 

Do you plan to move in the next 12 months?    Yes/No

 

Circle time away from home:        home all day      out part-time     away 7-10 hours daily   other_______

 

Where will this pet stay while you are gone during the day?____________________________________

 

Do you travel with your job? ________How often do you travel (pleasure/business)? _____________

 

Where will the pet stay when you travel? Answer required ___________________________________________________________________________________

 

Where will this pet sleep at night?___________________________________

Are you willing to purchase a crate if needed?__________   Do you have a pet door?____________

 

Are you planning to enroll your pet in a professional training program? _________ 

Will you take this pet to obedience class and/or commit to professional training if necessary for your new companion?________________________________

 

 

Do you plan to walk your dog off leash?  Yes/No  and if so when/where? ___________________

 

Do you plan to visit off leash dog parks with your dog?   Yes /  No

 

 

Renter info:  Does your landlord allow pets? Yes/No  Is a pet deposit required?  Yes/No How

much?____

Per pet or per household.  Is there a breed restriction? Is there a weight/size limit? Yes/No ____________size    Can proof of deposit be obtained from your landlord?  Yes/No

 

Name/# of apartment complex /landlord phone#_____________________________________________________

 

____________________________________________________________________________________

 

If you are applying to foster…would you be willing to foster until the dog is adopted?   Yes/No

 

What is the maximum length of time you would be willing to foster a particular dog?    __________

 

If you are applying to foster, would you be willing to foster a non-dog friendly dog and keep your current pets separated by use of a crate and rotating house/yard time with their pets and the foster dog?   Yes/No

 

 

PET OWNERSHIP HISTORY

 

Why do you want a Doberman?___________________________________________________

 

 

Is there a particular Doberman in which you are interested?_____________________________

Do you have a preference of cropped ears or natural ears? _____________________________

Do you only want cropped ears? ________ If so, why? ________________________________

 

Where did you see this Doberman or learn about Last Hope Doberman Rescue? _________________________________________________________________________

 

Have you ever adopted an animal before? Yes/No   If yes, from who______________________________

 

Have you ever given up an animal for any reason? or had it euthanized for any reason other than a

 

terminal illness?  Yes/No   If yes, please explain?_____________________________________________

____________________________________________________________________________________

 

Are you getting this animal for yourself? ____or as a gift_______ for______________________________

 

Please tell us what behaviors you are unwilling or unable to work through (after initial adjustment and training period attempted)     digging      chewing    barking  

jumping     eliminating in the house     thunderstorm/separation anxiety     Other____________________

Are you willing to call us for advice and work with a trainer on any of these issues if a problem persists?

 

Who will be primary caregiver?_________________ What type of food do you feed? ________________

 

Do you want your pet spayed/neutered?   Yes/No        Do you plan to chain your pet in the yard?   Yes/No

 

Can you keep your new pet away from your other pets in the house for at least one week when you are unable to monitor their interaction?   Yes/No

 

Total number of pets currently owned:   _______Dogs     ______Cats ________others

 

Number of pets NOT currently owned but owned within the last 10 years

                _____Dogs    _____Cats     _____others    Specify what happened to them _________________ ____________________________________________________________________________________

____________________________________________________________________________________

 

Are all the pets in your household current on shots?  Yes/No

Please explain what you believe causes heartworm disease? _______________________Please explain what you believe is the cost and risk of treating heartworm disease? _____________________________________________ _______________________________________________________________________________________________

 

On heartworm preventative?   Yes/No     What kind? _______________Given on what day____________

Where do you purchase your heartworm preventative? Vet __________ Other _____________________

 

What do you use for flea/tick prevention?

 

Do you know the risk of an expired rabies vaccination? Please explain: _______________________________________

________________________________________________________________________________________________

 

Name and Address of your Veterinarian____________________________________________

________________________________________   Phone #_____________________

 

List 2 additional references name and phone: ______________________________________________

___________________________________________________________________________________

 

Do you give us permission to call your veterinarian, other references and do a home check prior to adoption?  Yes/No

 

Please list all pets currently owned or owned in the past:

Include ALL pets currently in household or on premises.

 

Canine/Feline  Name:_________   Breed _____________M/F  Age ___mos/yrs  Owned: ______mos/yrs

Owned now?  Yes/No  If no: why not?__________________ Altered Yes/No if no, why not__________

Kept:     Totally inside        Mostly inside       Totally outside       Mostly outside       Declawed

 

Canine/Feline Name: _____   Breed ___________M/F  Age ____mos/yrs  Owned:______mos/yrs

Owned now?  Yes/No  If no why not?__________________ Altered Yes/No if no, why not__________

Kept:     Totally inside        Mostly inside       Totally outside       Mostly outside       Declawed

 

Canine/Feline Name:______   Breed ___________M/F  Age ____mos/yrs   Owned: ______mos/yrs

Owned now?  Yes/No  If no why not?_______________ Altered Yes/No if no, why not__________

Kept:     Totally inside        Mostly inside       Totally outside       Mostly outside       Declawed

 

Canine/Feline Name:______  Breed_ __________M/F  Age ____mos/yrs   Owned: ______mos/yrs

Owned now?  Yes/No  If no why not?__________________ Altered Yes/No if no, why not__________

Kept:     Totally inside        Mostly inside       Totally outside       Mostly outside       Declawed

 

 

 

Canine/Feline Name:______  Breed ___________M/F  Age ____mos/yrs   Owned: ______mos/yrs

Owned now?  Yes/No  If no why not?__________________ Altered Yes/No if no, why not__________

Kept:     Totally inside        Mostly inside       Totally outside       Mostly outside       Declawed

 

 

 

Do you agree to abide by our guidelines and to return the pet to us if you cannot keep it; and to notify us if the pet is lost or dies?  Yes  no (circle one)

 

I understand if the information provided on this application is incorrect or untrue, I will surrender this pet to LHDR upon demand.  I agree to allow a representative to inspect my home and yard and if any violations of the contract are in evidence, I agree to allow an agent of LHDR to remove the animal from the premises and this entry shall not constitute trespass. I certify that all the information in this application is correct and complete to the best of my knowledge.

 

 

Signature_____________________________________________________ Date:______________

 

Contact information:    Last Hope Doberman Rescue   http://www.lasthopedobermans.org 

Francine Case:           903-599-2219      Francinecase@windstream.net

Jennifer Rentfrow:     817-996-1734        greeneyes1734@gmail.com