Adopt – Royal Animal Refuge

Dog Choice #1

Dog Choice #2

Please list any preferences (age, sex, breed, color, personality): *

Applicant Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone *

Secondary Phone

Email *

Email

Confirm Email

How long have you lived at this address? *

Employment

What is the name of your employer? *

How long have you worked there? *

Tell Us Why You Want to Adopt and What Your Home Life Is Like

For whom are you adopting the dog? *

Myself
For a gift
For whom are you adopting the dog?

Why do you want to adopt a dog? *

Who will be the main caregiver of the dog? *

Does everyone in your household agree to adopting the pet? *

Yes
No

What do you think are the most important responsibilities in owning a dog? *

Your age: *

Who do you live with? (Check all that apply) *

Spouse/Partner
Roommate(s)
Relatives
Alone

Are there any children in the house? *

Yes
No

If yes, what are their ages?

How many adults (18 or older) live in your household? *

Your New Dog

Dog's living situation (check all that apply): *

If other, please specify:

When home alone, the dog will be (check all that apply) *

If other, please specify:

How will you exercise the dog? (Check all that apply) *

Leash walks everyday
Cable or dog run in the yard
Will be free to run in fenced yard
Will have supervised access to unfenced yard
Will be free to roam around (off leash and unsupervised in unfenced area)
Will take to the dog park
Other

If other, please specify:

Where will the dog sleep at night? *

Yard Size: *

Small
Medium
Large
None

Is the yard enclosed by a fence? If yes, what is the height, length, and type of fence? *

What type of residence do you have? *

If other, please specify:

Do you: *

Own
Rent

If you are renting, please provide the Landlord's name and phone number for verification of pet policy:

If your landlord allows dogs, is there a weight/size/breed restriction? If yes, what is the restriction?

Other Pets and Experience

Do you have other pets living with you now? *

Yes
No

If yes, please list what type of dog or cat, breed, age, neutered or spayed, owned for how long?

If you are applying for a puppy or dog that is not housetrained, how will you housetrain the dog?

How do you plan on transitioning this new pet into your home? *

Are you familiar with heartworm disease and how to prevent it? *

Have you ever given up a pet for adoption? *

Yes
No

If yes, please explain:

Vet Reference: *

Please provide the name and phone number of your current veterinarian(s) or the one who saw your previous pet(s). Vet references are required if you have previously owned or currently own a pet.

Personal Reference: *

Please provide the name and phone number of a personal reference not related to the applicant(s). Personal reference is required.

Additional Information

Please provide any additional information you would like to include about yourself and/or the dog you would like to adopt:

Thank you for your interest in adopting a Royal Animal Refuge dog!

Royal Animal Refuge is operated by volunteers and funded by donations. Royal Animal Refuge has a 501(c)(3) status.

I have read the above information carefully and have filled out 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 the Royal Animal Refuge reserves the right to annul the adoption and reclaim the animal. I grant Royal Animal Refuge full permission to verify the information provided as well as contact veterinarians and other references. If the application passes the review, I agree to a home and yard visit on a mutually agreed date by a Royal Animal Refuge volunteer before an adoption decision is made.

Royal Animal Refuge reserves the right to refuse any adoption.

Signature (please type your full name) *

Adoption Application

Applicant Information

Employment

Tell Us Why You Want to Adopt and What Your Home Life Is Like

Your New Dog

Other Pets and Experience

Thank you for your interest in adopting a Royal Animal Refuge dog!