Which dog are you most interested in adopting?
Name
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First Name
Last Name
Age
*
Primary Phone
*
(###)
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Secondary Phone
(###)
###
####
Email Address
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Employer Phone
(###)
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Employer's Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Work Schedule
Co-Applicant Name
First Name
Last Name
Co-Applicant Age
Relation to Primary Applicant
Co-Applicant Primary Phone
(###)
###
####
Co-Applicant Secondary Phone
(###)
###
####
Co-Applicant Employer Name
Co-Applicant Employer Phone
(###)
###
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Co-Applicant Employer Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Co-Applicant Work Schedule
List all people living in home
*
Name(s), Age(s), Relationship(s) to applicant
List all frequent visitors to the household
*
Age(s), Gender(s), Frequency
(Ex. Daughter every-other weekend, grandchildren one night a week, customers to your in-home business, seven men every Tuesday for poker night...)
List all animals in your home and on your property (including livestock)
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Name(s), Species/Breed(s)
Are all animals spayed/neutered?
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Yes
No
Are all other animals up-to-date with their vaccines?
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Yes
No
Do you own or rent your home?
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IF YOU RENT YOUR HOME, SPERANZA REQUIRES A LETTER FROM YOUR LANDLORD STATING THAT YOU ARE ALLOWED TO HAVE A DOG IN THE RENTED HOME. THE LETTER MUST ALSO STATE ANY BREED AND SIZE RESTRICTIONS ON THE PROPERTY. YOUR APPLICATION WILL NOT BE PROCESSED UNTIL YOUR SEND THIS LETTER TO ADOPT@SPERANZARESCUE.ORG.
Own
Rent
In what type of home do you live?
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Single-family home
Apartment
Townhome/Condo
Is there a fence?
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Please tell us what kind of fence you have, if any. We typically do not adopt to homes where an underground/electric fence is the only means of restraint for the dog.
No fence
Underground/Invisible Fence
4 foot chain link or privacy fence
6 foot chain link or privacy fence
How many hours a day will your adopted animal be home alone?
*
Where will your adopted animal live?
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Access to whole home/yard, in limited space in home/yard, or a different living arrangement?
Veterinary History
*
Please provide name, address and phone number of all veterinarians used during the last three years.
References (two required)
*
Please provide the name, relationship to adopter, number of years known and phone number of your first reference.
References (two required)
*
Please provide the name, relationship to adopter, number of years known and phone number of your second reference.
Are you prepared to house-train your dog? How will you house-train?
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Do you have experience (obedience) training dogs?
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How will you help your new dog transition?
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Many of our dogs have never lived in a home and will need patience, consistency, and time to adjust to their new surroundings and really come out of their shell.
Are you prepared to handle any and all costs associated with owning a dog?
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This could includes leashes, collars, food, toys, crate, regular vaccinations, emergency veterinary costs, grooming supplies, and many other unexpected costs.
How would you describe your family's activity level? What types of regular activities do you partake in?
*
How will your new dog get exercise?
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How will you include your new dog in daily activities and continue their socialization?
*
Have you ever owned a dog before? How many? If so, what happened to it/them?
*
In the past, have you ever gotten rid of a dog before due to behavioral issues? If so, what behavioral issues and what did you do with the dog?
*
What behaviors would you not be able to tolerate as an adopter?
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Mouthiness
Excessive Barking
Potty Training Accidents
Dog Aggression
Food Aggression
Anxiety (separation, travel, new people)
Chewing
Destruction of Household Items
Pulling when on a leash
Other
If other, please describe in more detail.
Are you willing to allow Speranza to come to your home for a home-check?
*
Yes
No