JR’s Pups-n-Stuff - Rescue
Adoption Application
In order to be considered for an adoption you must: **Be 21 years of age** Have the
knowledge
and consent of all adults living in your household**Have a valid ID with current address**Have
landlord’s name and telephone number (or lease)**Understand that JR’s Pups-n-Stuff must approve
your application** We do not adopt puppies (dogs under 6 months of age) to families with kids
under the age of 8.
Name (First, Last and MI):
Age/DOB:
Spouse/Partner Name:
Age/DOB:
Other Adult Name:
Age/DOB:
Street Address:
City:
State:
Zip:
Phone 1:
Phone 1 Type
Phone 2:
Phone 2 Type
Email Address:
**The legal name and date of birth is required for all adults residing in the home. If more than 3 adults live in
the home, please use comment section for additional information.
1. Is there a specific dog on the website you are interested in?
If yes, what is the dog’s name?
2. What type of pet are you looking for (check all that apply) ?
Male
Female
Adult
Puppy
3. Are you looking for a specific breed?
If Yes, what breed?
Have you researched this breed to determine whether or not it is appropriate for your home/living
environment?
4. Do you want this pet for:
Companion
Protection
Breeding
5. This pet will be without human companionship for about
6. Where will you pet be kept (check all that apply)
During the Day?
INDOORS
OUTDOORS
DOG PEN
GARAGE
OTHER
During the Night?
INDOORS
OUTDOORS
DOG PEN
GARAGE
OTHER
Gift
hours per day,
CRATE
BASEMENT
CRATE
BASEMENT
Other
days per week.
7. Where do you live?
AND I
**If you rent, you MUST provide the answers to the following questions:
1) Does your landlord allow pets?
2) Is a deposit required?
If Yes, what amount?
3) Monthly Rent Increase?
If Yes, what amount?
4) Landlord’s Name:
Phone :
**You must provide written authorization from your landlord in the form of a letter or a copy of your lease.
8. Are you familiar with the local ordinances regarding dog ownership in your community?
9. Are there any restricted breeds (those not allowed in your complex or community)?
If Yes, what breeds?
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10. Are there any breeds with restrictions in your community/complex (the breed is allowed but must have
specific training, fencing, etc.)?
If Yes, please explain?
11. Is there a weight limit for dogs in your complex or community?
If Yes, what?
12. Do you understand that by adopting a dog, you are required to comply with all local ordinances,
including licensing?
13. Do you have a fenced yard?
If Yes, please describe height, materials, and condition of the fence:
14. Please provide the following information about your household.
Number of Adults:
Number of Children:
Ages:
15. If you have children, what exposure to animals have the children had in the past?
16. At what age do you think it is appropriate for a child to be left unattended with a dog/puppy?
17. Is anyone in your family allergic to animals? CATS
If yes, what is done to manage the allergies?
DOGS
18. What will you do with your pets if you move in the future?
19. How much do you anticipate spending yearly to feed, vaccinate, license and provide medical care for
your pet? $
20. Do you have a limit on what you would spend for a medical emergency?
If yes, what is that limit? $
21. Are you familiar with the closest Veterinary Emergency Clinic in your area?
22. What do you consider an appropriate reason for euthanasia of a pet?
23. Would you be willing to allow a representative from the shelter visit your home before the adoption is
completed as a part of the approval process?
24. Have you adopted an animal from us before?
name?
If Yes, when and what was the animal’s
25. Do you realize a dog may live 15 years?
26. Adding a pet to your family is a lifetime commitment. Are you prepared to make a commitment for the
entire life of your pet?
27. It may take your new pet several weeks to adjust to its new home, especially if other pets or children
are involved. This transition time may include some undesirable behaviors that will require extra
time/attention. Are you prepared to allow this much time?
28. Adding a new pet will require transition time for any existing pets. This could take your pet (s) several
weeks to adjust to his/her new companion. Are you prepared to allow this much time?
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29. What steps are you willing to take to help your pet adjust to his/her new home?
30. What conditions would cause you to re-home (return to rescue) your pet?
31. Do you understand that even house trained dogs may have accidents, especially during transitions or
stressful times?
32. How do you plan to house train your dog?
33. How do you plan to exercise your dog?
34. Are you familiar with off leash dog parks in your area?
35. What type/brand of food do you plan to feed you dog?
36. Are you familiar with the pet supplies stores in your area?
37. What type(s) of pets do you own or have owned in the last 10 years? Please list ALL household pets.
If you no longer own the pet, please be specific as to what happened to the animal. If you have an
unneutered dog/cat, please explain why you have not altered the animal.
1. Pet Name:
Type
Breed (dogs):
Kept Where?
Age (current or when no longer owned):
Sex?
Spayed/Neutered?
If No, why not?
Still own?
If No, what happened to the animal/when?
Is your pet current on all required vaccinations?
If No, why not?
2. Pet Name:
Type
Breed (dogs):
Kept Where?
Age (current or when no longer owned):
Sex?
Spayed/Neutered?
If No, why not?
Still own?
If No, what happened to the animal/when?
Is your pet current on all required vaccinations?
If No, why not?
3. Pet Name:
Type
Breed (dogs):
Kept Where?
Age (current or when no longer owned):
Sex?
Spayed/Neutered?
If No, why not?
Still own?
If No, what happened to the animal/when?
Is your pet current on all required vaccinations?
If No, why not?
4. Pet Name:
Type
Breed (dogs):
Kept Where?
Age (current or when no longer owned):
Sex?
Spayed/Neutered?
If No, why not?
Still own?
If No, what happened to the animal/when?
Is your pet current on all required vaccinations?
If No, why not?
38. Who is (was) your veterinarian for the above animals? If your pets see different vets, please list all vets
you are using/used. (Applications will NOT be processed without this information).
Vet/Clinic Name:
Phone:
Vet/Clinic Name:
Phone:
Vet/Clinic Name:
Phone:
Please contact your veterinarian(s) and ask them to release information to our representatives.
Failure to do so can significantly delay the process. Your vet will be contacted to verify information. If
the vet records are under another name (married/maiden, parents etc.) please provide that name:
39. If this is your first pet, how do you plan to pick a veterinarian?
40. What is your desired time frame for adopting?
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Comments or additional information you would like to provide to assist us in identifying the correct dog for you.
Any additional adults should be listed here. Include full name and Date of Birth:
Any additional animals should be listed here. Include answers to all questions regarding the animals as asked
in question 37:
By signing below, I certify that the information I have given is true and I recognize that any
misrepresentation of the facts may result in my losing the privilege of adopting a pet. I authorize
investigation of all statements on this application. Verification of vetting, landlord and available public
records will be checked for accuracy of information. I understand that this application is property of
the JR’s Pups-n-Stuff.
Signature:
Date:
(Typed or electronic signature accepted.)
Applications may be mailed back to: JR’s Pups-n-Stuff, Inc.
450 S. Curtis Road West Allis WI 53214
Or completed applications may be emailed to: applications@jrspupsnstuff.org
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