Displaced Pets Rescue - Adoption Application

Before proceeding with this application please note - we only place our dogs within the Pacific Northwest area,
which includes, Washington, Oregon and Idaho. Applications from other states are discarded.

* Indicate which dog/puppy you are looking at from our WEB site, please indicate which one. If you are not looking at a specific one indicate if there are specific characteristics (color, size, sex) you want. Indicate why you are interested in this particular dog.

This questionnaire is intended to help us in making the best match possible. Be detailed in your answers as it will give us a better picture of you and the home you will be providing. Be patient in your answers, this information is the main part of starting my determinations. The more detail you give me the better I am able to decide if this is the right pet match. You don't want to be skipped over because someone offered more detailed responses for the same skill set. Applications with short yes/no types of answers, or with a lot of skipped questions, are not considered.

You need to give me your complete physical address. We are not able to process an application that does not have an address or offers a PO box. It must be a complete physical address.

Your full name:

Physical Address:

City, State and Zip:

County (NOT Country)

Your email address:

Telephone:

(Please let us know how you came to find us, eg: Google search, Pet Finder, PetSmart, Rescue Me, referral from Jane Doe, picked up business card at XYZ business. etc.)

How did you find us .

How long have you lived at this address?

Do you rent, own, or live with relatives

If you are renting we need to contact your landlord for reference and to verify pet status in the home. Indicating their information here is your agreement to our contacting them.

If renting indicate landlord's contact information

Have you or anyone in your household been charged with animal or violence related charges?.

Yes
No
Yes - With An Explanation

If you indicated "Yes With An Explanation" give that explanation here.

Please know we take our job seriously. We will be contacting your local animal control, shelters and/or police departments, in your area, to ensure no animal related or violent issues have been filed.

Tell me about other family members in the home, children, parents, etc., be sure to indicate ages of children and some family activities (eg. Johnny is 13 and is much involved in sports, his favorite is hockey.)

List other pets in the home. Include the following: Dog/Cat, Breed, Age, Male/Female, Spay/Neutered, Current on Vaccines.

Name, location and contact information for your Vet. Indicating their information here is your agreement to our contacting them for a reference.

Do you have other references for us to contact?

Do you have friends or relatives who would take care of this dog, or facilitate returning it to Displaced Pets Rescue, if you became unable to care for it? If yes, please indicate name and contact information.

This next section is information about your home, experience and training.

If you have ever owned a pet before describe the experience.

Describe the home you will be giving your new pet. Indicate if you are in a house or apartment and if you have an enclosed yard or nearby open space for play (such as a park). Will this dog be an indoor or outdoor pet?

Explain what being a caretaker of a pet means to you.

Indicate the length of time this pet might be left alone. Include the surroundings that the pet will be left in while you are gone (eg. outside in fenced back yard, kenneled, run of the house, other). If your yard is fenced is it secure enough for a small dog.

If you have ever taken in a rescue before, indicate with what organization and describe the experience.

Indicate the experience you have had in training animals (ie. House training, basic commands, etc...)
.

If you would be willing to support a rescue with special needs indicate if you have had past experience in supporting a special needs pet. Indicate what the special needs were. Also, indicate what special needs you would be willing to take on. Include behavioral issues with these needs (ie. resource guarding, fear, biting, health issues).

Have you even been in a situation where you had to bring a pet to a shelter? If yes, please explain.

If you travel, who will care for your dog while you are away?

Describe some issues that you think you might have to deal with in being a guardian to the age group of pet you are looking at.

What would you expect the annual cost of dog food, toys, vet care, grooming, etc. for your pet?

What is a reasonable amount to spend on your dog if he became sick.

What are some possible circumstances that would cause you to give up this pet?

Training

How much training are you comfortable doing with your dog to improve manners such as potty training, jumping up, separation anxiety, barking, or pulling on leash?

Have you ever done training with a dog? if yes, please explain the type of training you have worked with.

Are you willing to housetrain? If yes, using what methods.

How would you respond to the dog eliminating in unacceptable places?

Do you understand and accept that a change in a dog's environment may cause the dog to have accidents, especially in early days of the adoption. Explain how you intend to get them through that transition, to understand the new environment and what is expected of him.
.

How will you discipline your dog if he/she misbehaves?

What would you do if the undesirable behavior continues?

Please explain what you would do if your dog developed a problem with the following: We understand that it may be difficult to predict your response to each individual scenario, however we are looking for your general view on the philosophies of training. Please provide thoughtful and thorough answers. The more detail you provide the better vision I have of your skill level.

How would you respond to digging?

How would you respond to destructive chewing?

How would you respond to excessive shedding or hair loss?

How would you respond to the dog keeping you awake at night?

How would you respond to the dog jumping on family members or guests?

How would you respond to the dog growling at family members or guests?

How would you respond to biting of people?

How would you respond to a dog with aggression or other dogs/animals?

How would you respond to a dog with separation anxiety?

Agreements

We are a non-profit organization. The adoption donation is used to partially recover the costs involved in rescuing this dog. Donations are used 100% for the dogs. Our expenses include but are not limited to: Shelter fees, spay/neuter, food, housing, vaccinations, de-worming, registered microchip, and any vet exams or medical care that the dog may have required. We would not have been able to save the life of the dog you applied for without the adoption donation from another that came before him/her. Our adoption donations range between $200 and $400 depending on the age, medical condition and place-ability of the pet.

Are you willing and able to make the donation fee?

Yes
No

We reserve the right to inspect all potential homes and yards prior to placement. Is this agreeable to you?

Yes
No

I understand that Displaced Pets Rescue has the right to annul the adoption should an un-truth be identified in this application.

I agree
I dis-agree

Other information or comments you wish us to know. Are there questions and/or concerns that we can help you understand?

I have read the above carefully and have filled out this application honestly. I understand that an omission and/or failure to answer all questions can result in the application being declined. If an untruth is discovered after an adoption takes place, and this untruth puts the rescue animal at risk, that animal will be removed.

Clicking this Submit button is your signature that all of the above is true and that the person completing this application is 18 or older. This application becomes part of the adoption contract.