First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Text/Pager Email

Please select whether you are applying to foster or adopt

Spouse's (or significant other) Full name*

Age*

Applicant Age*

Please list the name of any other adults living in your home? Please name them, list their relationship and ages: *

Please list Name & Age of all children living in your home: *

Your Employer*

Hours you work per week?*

Spouse's Employer*

Spouse's work phone number (include area code)*

Hours your spouse works per week?*

How long have you lived in your current home?*

If you have lived at your current residence for less than 2 years, please provide your previous address (street, city, state & zipcode)*

In what type of home do you live?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home?*
Choose one: Rent Own

If you rent, have you received the approval of your landlord to have an animal*
Choose one: N/A No Yes

If you rent, please enter your landlord's name and phone number*

Please provide the name of your Home Owner’s Association (where applicable), the contact person, and a phone number.*

Do you know if your city or county has animal ordinances/licensing procedures in your area?

If yes, what are they?*

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

Where will the animal be kept when you are home*

Where will the animal sleep*

Where will the dog be kept when you travel? *

Where will the animal be kept when you are not home*

How much time will the animal spend alone during the day*

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What type of fence*
Choose one: Privacy Chain Link Invisible No Fence

What is the height of the fence*

Have you ever owned a Rottweiler or any other breed Dog ?

Do you currently have any other pets?

If you own or have owned a dog, is it/was it (check ALL that apply):
Choose all that apply: Spayed or Neutered Current on Vaccines On Heartworm Preventative On Flea/Tick Control

If yes, please describe the pets in detail: Name, Age, How long in your home, Full description including sex *

If not, please explain why: *

If there were previous dogs, what happened to them? *

Do you have a crate?

Are you willing to purchase a crate, if needed?

Why are you interested in adopting at this time*

What steps have you taken to learn about this breed and/or dog ownership? *

Are you willing to take the dog to obedience classes?

Why or why not? *

What behavioral/training issues can you ‘not’ deal with? *

ARRF will provide an honest evaluation of the temperament of every ARRF dog to the best of our abilities. If behavioral problems present themselves at a later day, are you committed to working with the animal to correct the problem?*

What length of time do you feel is adequate to allow a dog to adjust to your home? *

Veterinarian's Name, Address and Phone Number*

If you have recently changed Vet’s and it is less than one year; please also list the name and number of your previous Veterinarian.*

Do you prefer?

If this application is for a docked breed, Will you consider adopting the dog if it still has its natural tail?

Is there a certain Dog you are interested in, if so, which one?
Choose an animal: Butterscotch Crosby Dalton Dixie Dusty Dusty Jack Mickey Neila Niko Pebbles Petey Reed Remi Romeo Sinatra Wilbur

Please list the name of the dog your are interested in adopting if it is NOT listed above.

Has any member of the household ever been charged and/or convicted of any type of animal cruelty or abuse.

Who will be responsible for the caring for your dog if something should happen to you?*

If you move, what do you plan to do with your pet(s)? What if where you are moving to has dog restrictions?*

Have you considered the annual expenses of medical, food, grooming, etc.?

How did you hear about ARRF?*

Have you applied with any other rescue If so, which ones?*
Choose one: Yes No

I certify that the above information is true and I understand that prior to being approved for adoption, the above information will be verified. In all cases, a home visit will be required. I also agree to a personal interview with a member of ARRF, if required, to determine the suitability of my home/facility to care for a canine. I also understand that if at any time ARRF feels the dog is not being cared for properly, or feel the dog is being abused; ARRF will take back possession of the dog. In the event that you can no longer keep the dog, ARRF must be notified immediately. I understand and agree that falsification of any of the above information is grounds to disqualify my adoption application and nullify all adoption(s) and/or adoption agreements between the applicant and ARRF. I understand my electronic signature is legal and binding. I authorize ARRF to attain any information needed from all above references. Please initial here *

Applicant(s) Signature*

Date*