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This is not a form you can fill out online. You need to copy and paste this in an email, edit/type in your answers, and email
to me. Email link at bottom of page.
This helps me to properly 'match' dogs and families.
~~~~~~~~~~~~~~~~~~~~~~~~Thank you!~~~~~~~~~~~~~~~~~~~~~~~~
ADOPTION APPLICATION ----- S NV Samoyed Dog Rescue
To help ensure the best possible placement of our rescued dogs, and in order to determine that the proposed adoption is
in the best interest of both the dog and you and your family, please complete the following. Be thorough as incomplete applications
will not be considered. If you have any questions, please feel free to contact S. NV Rescue. email nvsammysue@earthlink.net
Susan L Las Vegas NV 89118
Date
Information about you:
Full Name
Address
How long at current address?
All telephone numbers to reach you:
What is the best time to call you?
Email:
With whom are you employed?
Spouse's employer?
Occupations
Number and ages of children in household:
How many days (or hours) are the children at home per week?
Are you getting this dog for your kids?
Must the dog be kid-compatible?
Do your kids know how to behave around dogs?
Have they ever had a dog before?
Are you over 21?
Information about your home:
What type of area do you live in:
What type of housing?
Do you rent or own your home?
or live with a parent/friend/relative?
Do you live with someone who has final permission or influence on approving your pet adoption?
May we contact that person? Phone:
Do you live in a covenant controlled community/subdivision?
If so, are you aware of any restriction and/or regulation concerning pet ownership?
If you rent or lease, do you have permission from your landlord to own a dog? Yes/No N/A
May we contact your landlord? Yes/No Phone
Address
Pet history/preferences: What pets do you have now?
What dogs/pets have you previously owned?
Why are they no longer living with you?
How have you educated yourself about owning dogs /particular breeds?
How did you hear about this rescue/who referred you?
Is there a particular dog I have that you are applying for? (which one?)
Sex preference of dog ?
If the sex matters, why?
Any age preference? Why?
Is a mixed breed Samoyed acceptable?
Must the dog be house broken?
Must the dog be completely obedience trained?
Please note that I usually do not have fully trained dogs. Are you ready to accept the responsibility of training this
dog, if necessary?
Would you consider a dog that is not exactly your preference?
Owning the dog:
Do you have a fenced yard?
Height
Type
If you do not have a fenced yard, where and how will the dog be exercised and be allowed to eliminate?
What member of the family will be taking the MAJOR responsibility of caring for this dog?
What are your plans and goals for this dog? What activities will you and your family participate in with this dog?
Have you ever trained a dog in obedience classes?
Will you take your dog to obedience classes?
Will the dog live IN the home?
Where EXACTLY will the dog sleep at night ? (outside/inside/what room etc.)
and be kept when there is no one at home?
Do you believe in using dog crates? Why?
If you change homes/move, what will you do with your dog? (keep it, give it away, return to rescue? etc)
When you go on vacation, where will your dog go and who will care for it?
Who is/would be your vet?
Name
Phone
Address
How will your dog travel to the vet or other places? (in a car, van, back of pickup, etc.)
Do you mind if we call your vet to ask how you take care of your animals?
If yes, why?
Have you ever surrendered a pet of yours to an animal shelter or sold or given one away?
If yes, why?
May we visit your home to verify the information you have provided?
These questions bear repeating - just think about these: Will you train your dog? How are your kids with pets? Did you
clear it with your spouse, your landlord, your HOA, your parents? When you move or divorce or have a baby or the kids move
out or you graduate from school or whatever big change occurs in your life, will the dog be a part of it? Can you make the
over 10 year commitment? Dogs live as long as 15 years!
Do you understand that the commitment to a dog can be OVER 10 YEARS?
In the space below, please tell us a little about yourself and why you feel you could provide a good home for a rescue
dog. Also write any concerns/questions:
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