Adoption Application
Box 159, Cando Sk, S0K0V0
(306) 948-9519 brilynjiricka@hotmail.com
www.prairiepoochesrescue.com
Adopter’s Information
Name(s): _______________________________________
Email: ________________________________
Mailing Address: ___________________________Physical Address: _________________________________
City: ________________________ Prov:__________ Postal:_____________________
Phone: (home)________________________________ (cell)_______________________________
Which pet are you interested in or specify what kind of pet you are looking for.
Living Accommodations: House/Owned/Condo/Apartment/Other/landlord info:
Do you have any other pets in the house- Name: Species: Breed: Age: Sex: Spayed/Neutered:
List of persons in the household (including yourself)- Name: Age: Occupation:
Have you ever owned a dog before? If so what happened to the dog?
Have you ever surrendered a pet to the SPCA/shelter/rescue? If yes why?
The following questions are to determine the right fit for you
Why do you want to adopt a pet:
What experience do you have with the particular pet/breed:
Who will be the main caregiver(s) of the pet:
On average, how many hours per day are you away from home:
Will your pet be inside or outside?
If you adopt a dog, will your dog ever be used for guarding purposes?
Do you have a designated area for the pet to stay while you are out of the house, explain:
Where will your pet sleep at night:
Do you have a fence or fenced area for your pet, if so how tall and what material:
What kind of activities would you like to do with your pet:
Are you interested in taking training for you and your pet:
Do you already have a regular Veterinarian? Provide contact information.
Are there any breed bans or restrictions to your town/city?
Does anyone in the household have any allergies to animals?
Are you willing to give the dog a couple weeks to adjust to its new life in your home? Please understand it
takes them sometime to become comfortable and get into a new routine.
What would the dog have to do for you to return it to Prairie Pooches Rescue? Are you prepared to deal with
habits such as kennel training, chewing, leash walking etc.
Please share how you plan to integrate the dog to any children or grandchildren that are in the family or may be
added the family. Sadly dogs are often returned b/c people are not willing to take time for both a child and dog.
We want to ensure you are prepared and willing to deal with this.
Please provide two references. Only one can be a family member.
Name:
Relationship:
Years Known:
Phone Numbers:
Name:
Relationship:
Years Known:
Phone Numbers:
1.
2.
3.
4.
5.
Do you agree to return the animal into Prairie Pooches Rescue’s care if no longer able to care for it?
Do you agree to take the animal to the vet for annual vaccinations and exam?
Do you agree to license the animal with your town/city?
Are you prepared to care for this animal for the next 10-15+ years it may live?
Are you prepared to deal with shedding and/or grooming it may require?
Other comments: