EmailMe Form - Poodle Rescue Adoption Application

IMPORTANT:

PLEASE NOTE THAT DUE TO THE INCREASING VOLUME OF APPLICATIONS RECEIVED, ONLY APPROVED APPLICANTS WILL BE CONTACTED AT THIS TIME. THANK YOU FOR UNDERSTANDING.

APPLICATION DISCLAIMER:

I certify that the answers given by me to all questions on this adoption application are, to the best of my knowledge, true and correct and that I have not knowingly withheld any pertinent facts or circumstances. I understand that any omission or misrepresentation of facts in this application may result in the refusal of my application to adopt a dog.

I hereby consent to permit Poodle Rescue of New England (PRNE) to contact anyone it deems appropriate to verify any information provided by me on this Adoption Application to discuss my suitability regarding the adoption of a dog. I understand that my home and family must be approved by PRNE before adoption takes place.

I understand that Poodle Rescue of New England will not place a poodle in a home with electric/invisible fencing. For your safety, Poodle Rescue of New England cannot place a poodle in a home with children under the age of 10.

I understand that PRNE adopts dogs within the New England area (MA, NH, ME, VT, RI, CT) and Upstate NY within a 1/2 hour of Albany.

I acknowledge that PRNE reserves the right to refuse any application if, in their opinion, the best interest of the poodle would not be served.

Accept Terms *

I have read the application disclaimer and terms of PRNE thoroughly.

CONTACT INFORMATION

Name *

First Last

Address *

Street Address City State / Province / Region Postal / Zip Code

NOTE: We adopt within New England (MA, NH, ME, VT, RI, CT) and Upstate NY within 1/2 hour of Albany ONLY.

Home Phone *

### - ### - ####

Mobile Phone

### - ### - ####

Email *

HOME INFORMATION

Do you rent or own? *

Rent

Own

If you rent, you must have written permission from your landlord to own a dog.

Type of dwelling? *

Home

Condo

Apartment

Years at current address: *

Do you have a fenced in yard? *

Yes

No

Please describe your fence below.

If yes, please describe the type of fence and whether it's secure on all sides (holes or gaps):

Could barking be a problem with neighbors? *

Yes

No

FAMILY COMPOSITION

Number of adults living in the house: *

List the exact age of each adult living in the household. Please list each age separately. *

Number of children living in the house: *

If none, please write 0.

Ages of all children: (include the age of each child living in the house)

Do children visit? *

Yes

No

If yes, how many:

Ages of visiting children:

Have you discussed the pros, cons and responsibilities of owning a dog with everyone in your house? *

Yes

No

Does everyone in the household want a poodle? *

Yes

No

Why do you want to adopt a poodle? *

PET OWNERSHIP HISTORY

Do you currently have a dog? *

Yes

No

Breed/Size

Age

Sex

Spay/Neuter

Describe dog personality

Do you have another dog?

Yes

No

Breed/Size

Age

Sex

Spay/Neuter

Describe dog personality

Do you have another dog?

Yes

No

Breed/Size

Age

Sex

Spay/Neuter

Describe dog personality

Previously owned dogs:

Breed
Breed

What happened to pet(s)? Please explain. *

List other pets living in the house: *

What, if any problems have you had with any of your pets and how did you handle them? *

CARING FOR YOUR NEW DOG

Who will be the primary caregiver? *

What is the age of the primary caregiver? *

Does the primary caregiver work? *

Yes

No

How many hours do you work and how long will you be out of the house (including commuting time)? *

How will the dog be cared for during work hours? Where will it stay? *

If you work from home now, will you eventually be returning to your office? If so, how will your dog be cared for while you're at work. *

Where will the dog stay when you are on vacation? *

Will your dog be allowed complete access to the house? *

Yes

No

Where will the dog sleep at night? *

What exercise plan do you plan for your dog? *

Do you plan on obedience training for your dog? *

Yes

No

What type of obedience training do you plan and what, if anything, have you done in the past? Please be specific. *

Are you prepared to spend $45-$150 every 6-8 weeks for grooming? *

Yes

No

YOUR RESCUE PREFERENCES

Size: *

Standard (avg 40-60lbs)

Mini (avg 10-25lbs)

Toy (under 10lbs)

Sex: *

Approx. Age *

Is there a specific dog you are interested in? If so, please add the name below. *

Yes

No

Dog's Name:

Would you be interested in adopting in the following circumstances:

A dog over 10 years of age

A dog with a disability (diabetes, blindness, epilepsy)

More than one dog

Regarding the above question, please explain in detail why, or why not. *

Activity Level (choose one): *

Active

Moderate

Sedentary

What traits (personality, social skills) are you looking for to best meet your needs. *

What, if any, activities would you like a dog to participate in (hiking, jogging, walking, therapy, agility)? Please list all. *

Are you willing to work with your new dog if he/she has housebreaking issues and if so, how? *

Are you willing to work with your new dog if he/she has behavioral issues? Please explain. *

What circumstances would cause you to give up a dog? *

Have you had to give up a pet in the past? If yes, please explain in detail. *

Are you prepared to care for your new dog for the rest of his/her life? This includes any unforeseen medical issues your dog may develop as he/she ages. *

What plans have you made to ensure your dog will be cared for should anything happen to you? *

Is your family able and willing to commit to care for your new dog (who may be old at the time) should you become incapacitated? *

MISC

It takes time for a new dog to adjust to his/her new home. How will you help your dog through this process and how long do you anticipate it will take? *

How will you help all of your other animals adjust during this period? *

What kind of food do you feed your dog? Please list brand. *

PRNE requires a home visit. Are you willing to allow a volunteer visit your home? *

Yes

No

Will care arrangements change in the next 6 months to a year? *

Yes

No

If yes, explain:

Our dogs are in foster homes throughout New England and Upstate New York within a half hour of Albany. Are you willing and able to travel to meet the dog you are interested in meeting? *

Are you planning to adopt a dog now or in the future? Please explain. *

REFERENCES

Please contact your Veterinarian and Groomer and let them know we will be calling for a reference. Permission must be given before we can obtain a reference. If you don’t have a current vet, please provide two personal references.

Veterinarian: *

If you don't have a vet, please list another reverence.

Phone *

### - ### - ####

Address *

Street Address City State / Province / Region Postal / Zip Code

Groomer: *

If you don't have a groomer, please list another reverence.

Phone *

### - ### - ####

Commitment: Check all that apply. *

I am willing to spend the time to train and socialize my dog.

(Homes with children) I have taught my children the proper way to responsibly care for pet.

(Homes with other pets) I am prepared to spend the time necessary to acclimate them to one another and isolate them during the adjustment period if necessary

If your form does not submit please scroll up and make sure you have completed ALL required fields. Incomplete applications will not be accepted.

Poodle Rescue New England

PO BOX 47, Sudbury, MA 01776
A 501(c)(3) non-profit organization
MA License Number 0584