RezQ Dogs Adoption Application
PO Box 8
Dodson, MT 59524
406-262-8122
adoptions.rezqdogs@gmail.com
Incomplete applications WILL NOT be considered
Name(s):
Email:
Address:
City:
State:
Zip:
Home Phone:
(
)
Work Phone:
(
)
Cell:
(
)
Name and ages of all household members:
Name of employer:
If you are interested in a particular dog, please enter its
name here:
What attracts you to this particular breed?
Why are you interested in this particular dog?
Are all household members in favor of this adoption?
Is anyone in the household allergic to pets?
Have you ever owned a dog before?
Do you expect your current family situation to change?
What type of dwelling to you live in? (House, apartment, condo, townhouse, etc.)
Do you own or rent?
If you rent, please provide landlord's name and phone number:
Do you have a fenced yard?
If yes, how tall is the
fence?
What type of fence?
Kennel or run:
Describe the area:
How long have you lived there?
Do you plan on moving in the future?
If so, what will happen to the dog?
Have you ever had to relinquish or surrender an animal in the past?
If so, please explain the circumstances:
Please list all pets in household (include type, breed, age, and sex):
Do you still have these animals?
What happened to those you no longer have?
Spayed or neutered?
If no, why?
Are your current pets up to date on vaccinations?
Are your current pets accepting of new dogs in their house?
What will your dog need to get along with (small animals, women, men, children, cats, livestock, birds, loud noises, high
activity)?
Why do you want to adopt a dog from us (house pet, guard dog, companion for children, gift, agility, herding, obedience,
tracking, therapy or assistance work, etc.)?
Is someone home during the day?
If not, how long will this dog be left alone?
Where will this dog be kept while home alone?
Where will this dog be kept when the family is home?
Where will this dog sleep?
How will you confine and exercise this dog?
Are you willing to buy and use a crate if recommended?
Are you willing to attend obedience classes if needed?
Rescued dogs may lack household manners as few of them have lived in home environment prior to adoption. What experience
do you have with dog training and/or working with dogs to instill house hold manners (Please specify methods used)?
Would dog be allowed to ride in back of pickup? Why or
why not?
Would you allow a home visit?
References: Please list two personal references who have known you for at least two years (We recommend listing your dog
trainer, neighbor, personal friend, or co-worker; and no more than one family member.) and your veterinarian. Be sure to include
their name, address, and phone number. All references will be checked.
1)
2)
Veterinarian
I am in full agreement with the attached Terms of Adoption and understand that if I ever relinquish the dog that said dog
must be returned to RezQ Dogs or their designated representative. By submitting this application I am attesting to the
truthfulness of my answers. I understand that falsification of any information given in this application or in any other
medium will be grounds to disallow the adoption of a rescue dog.
An adoption fee of $125 for adult dogs and $150 for dogs under 1 year of age to help cover the costs of spay/neuter,
vaccinations, and other foster and transport costs incurred, is due at the time of placement. Submission of your
application does not guarantee placement of a dog. I understand that a vet reference and a home visit may be required
for adoption and that RezQ Dogs reserves the right to refuse any applicant for any reason.
Applicant
SIGNATURE:
DATE:
Co-Applicant
SIGNATURE:
DATE:
OFFICE USE ONLY
Home check date:
Home check completed by:
Home check notes/issues:
Date references contacted:
References contacted by:
Reference notes/issues:
Approved for adoption:
Yes
No
Signature
Date:
RezQ Dogs Adoption Application
Providing hope for those with none
PO Box 83
Dodson, MT 59524
406-262-8122
adoptions.rezqdogs@gmail.com
Terms of Adoption
The following agreement specifies what we feel is required to provide a safe and loving home for a
dog. Please understand that the details of the contract reflect our concern that both owner and dog
have a happy life together. The conditions set forth are based on years of experience and a
continuing commitment to see that our rescue dogs find safe and happy permanent homes. We hope
that you will understand that considerable emotional involvement, time and energy go into insuring
that our rescue dogs have the best possible second chance at life.
If I am successful in the adoption of a dog from RezQ Dogs, I herein promise and agree to the
following conditions:
1. To contribute an adoption donation in the amount of $ 125 (dogs >1 year old) or $150 (dogs < 1 year
old). Donation is fully refundable if dog is returned to RezQ Dogs or their designated representative within
30 days for any reason.
2. To keep this dog in my personal possession, provide proper and sufficient food, water, shelter,
grooming and humane treatment at all times.
3. I understand that this dog has already been spayed or neutered at the time of adoption.
4. To procure veterinary care at once if it becomes sick or injured and to keep all vaccinations current as
recommended by my dog's veterinarian.
5. To provide him or her with an ID tag secured to a buckle collar (never with a choke collar), which will be
worn at all times.
6. To obey any and all animal control regulations governing the area in which I live, and to license this
dog according to such regulations within one month of adoption.
7. Not to sell, trade, transfer ownership, abandon, or dispose of this dog in any way, but to notify RezQ
Dogs or their designated representative if I must relinquish custody of the dog. This includes release to
family members.
Initial: _____________
8. To notify RezQ Dogs or their designated representative immediately if this dog is lost, or stolen and to
make every effort to locate the dog.
9. To allow RezQ Dogs or their designated representative to examine the dog and its living conditions and
to surrender it to said representative for return to the organization if the conditions are found unsatisfactory.
10. To assume full responsibility for this dog's actions, and for any damage done by this dog.
11. To exercise him/her in a safe environment and to never allow him/her to run loose without proper adult
supervision.
12. I agree never to allow him/her to be transported in the open bed of a pickup truck or similar vehicle.
RELEASE OF LIABILITY AND INDEMNIFICATION
I fully understand that RezQ Dogs cannot and does not make any representations or warranties, either expressed or implied,
concerning the temperament, health, habits or background of this pet and that future reactions to me, my family, my pets and
other persons and animals are completely unpredictable. Therefore, and in consideration of receiving this dog, I hereby release
RezQ Dogs from all claims of injury or damage, which this dog may cause me or my property. And I further agree to hold
harmless RezQ Dogs from any and all claims of liability to other persons for injuries or damage caused them by this dog while it
is in my care or custody. My selection of this dog has been based upon my own observation of the actions and temperament,
and I have selected this dog solely upon my own judgment.
Applicant Signature:
Date:
Co-Applicant Signature:
Date: