ARF Canine Adoption Application
We realize there are a lot of questions to answer. Please understand they are all for the best interests of yourself
and the dog for which you are applying. Please take the time to carefully read and complete the following
questions, which are designed to assist with placing our dogs in the correct environment for their personality
and needs. It is our intention to place animals with individuals or families who will consider them an important
part of their lives. We wish for the dog and the adoptive family alike to be content with the decision, and want
it to result in a permanent placement. Thank you for understanding.
This application may be completed on your computer, or printed out for completion. NOTE: When completing on computer, please
save file with the pet’s name and you last name, (i.e., Rover-Johnson.doc) to your hard drive, then attach the file to an email and send
it to the rescue volunteer listed on the pet’s posting.
Part I
Rules and Disclosure
As a potential adopter, please read the following section. Entering your initials at the bottom of this
document signals your acknowledgement and agreement to the following terms.

The purchase of a collar and leash is required before taking possession of the dog. Please bring a collar
and leash when you come to meet the dog.

Any monies paid as part of the adoption fee is considered a donation to provide care for this and other
homeless pets and are not refundable.

We make every effort to assure that the animal you adopt from us is healthy. We do this by having each
pet examined by our vets, and having it de-wormed and vaccinated against communicable diseases (to
include parvovirus, distemper and kennel cough). Occasionally, a pet may not show symptoms of an
illness until after he is adopted, as most illnesses have an incubation period of 17-21 days. This is
completely unavoidable and occurs not only in shelter/rescue type settings, but also with pet stores,
breeders and any environment where there are a number of animals present at any given time. We
require that your new pet be re-examined by a vet within 7 days after the adoption for its best interests.
A voucher for a free exam with one of our participating veterinarians will be enclosed in your adoption
packet. If you choose to visit an alternate veterinarian, you will be responsible for all medical expenses
incurred.

We strive for appropriate matches of dogs and adoptive families based on assessment of the animals’
temperaments (to the extent that may be judged by our representatives) as well as on careful evaluation
of potential adopters and the living conditions they will be able to offer a dog.

We have the right to approve or deny the adoption application. This application is used as part of the
adoption approval process in order to determine the best home for the animal. Not under any
circumstances will any dog be used in any type of dog fighting activity or as an attack dog, nor shall it
be kept with the intention of promoting aggressiveness or for breeding.

Dogs in our organization are typically rescued from shelters in Illinois or surrounding states, and are
cared for in private, volunteer foster homes, where they receive specialized and loving care in
family/household environments. Every effort is made to determine as much of each dog’s history,
health, and temperament as possible before the dog is made available for adoption.

The completion of this application does not guarantee adoption.
representative will contact me if I am approved.

I certify that I am 18 years of age or older, and have read and understand the conditions of this
adoption application by entering my initials here:
Page 1 of 3
I understand that a rescue
Part II:
Personal Information
(Use the tab key to quickly & easily move about the form.)
Date of Application:
Your Name:
Your Occupation:
Your Drivers License #:
Partner/Spouse Name:
Partner/Spouse Occupation:
Email Address:
Home Phone #:
Work Phone #:
Mobile Phone #:
Address:
City:
State, Zip:

Please indicate the name of the dog
you are seeking to adopt:

How long have you been looking for a dog?

What breed/mixture are you looking for, and why

Please list the ages and family relationship of the people with
whom this dog will be living.

If you have children:
what is their experience with dogs?

What are the ages of the children who will be living with or
visiting this dog?

Are there any allergies within your family that would be
affected by a dog in the household? Please describe.

Is everyone in the household in agreement that this dog would
be a good choice for your household?
No

I/We currently live in a
Apartment

Do you rent or own your home?
Own
If you rent, please provide your landlord’s name and phone
number.

Is your yard fully fenced?
No
If so, how high is the fence at its lowest point?

If currently own any other pets, please describe type, gender,
age, neutered/spay.

Are your current pets friendly with other dogs?

If your new pet does not get along with your current pets, how
will you deal with the situation?

What is the name and phone number of the veterinarian you
plan to use for this new dog?

Where will the new dog be kept while you are at home?

Where will the new dog sleep at night?

Will the dog be crate trained?
No
No
If No, how will you housebreak it or prevent it from causing
other mischief or household damage such as chewing,
jumping on furniture, etc?

Do you own a crate or cage for this new dog?
Cage
If yes, what size is it?
Page 2 of 3
Illinois,

What is the maximum length of time this dog will be left
alone at any time?

Are you willing to bathe or groom your dog on a regular
basis, or will you have it groomed professionally?

What experience have you had with training dogs?

How will you discipline your dog?

If the dog requires additional obedience training, are you
willing to invest the time, money and effort required to
provide that training?

How do you plan to exercise this dog?

If a medical emergency arises, will you be able to afford
emergency veterinary treatment for your pet?

If you must move in the future to living quarters that do not
allow pets, what will you do with your dog?

Have you ever surrendered a pet to an animal shelter or other
rescue organization, or lost a pet due to straying or by death
due to other than natural causes?
Professional Groom
No
If Yes, please explain

Please provide a personal reference and phone number:

Additional Comments:
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