E-MAIL THIS COMPLETE FORM VIA COPY/PASTE to: [email protected]
You can COPY AND PASTE (highlight text, right click on your mouse, click COPY, then in a new email to us, right click in the blank message space and hit PASTE. You can fill out these forms that way and type you full name and date at the bottom as your Online Signature)
You can COPY AND PASTE (highlight text, right click on your mouse, click COPY, then in a new email to us, right click in the blank message space and hit PASTE. You can fill out these forms that way and type you full name and date at the bottom as your Online Signature)
Pet Application Form
B LOVED RESCUE GROUP PET ADOPTION APPLICATION
[email protected] 717-712-8790
Completion of this application does not guarantee adoption of the animal.
INSTRUCTIONS: Please Note: Completion of this application does not guarantee adoption of the animal!! An application is required for anyone interested in adoption. Please remember this will not hold a dog! We do our best to hold a dog for the right adopter but can not guarantee adoption. To Fill Out & E-Mail: Copy and Paste the contents of this application into a new e-mail to us OR Scan the document OR print, fill out, and send us CLEAR pictures taken from your cell phone directly above this application showing everything as clearly as possible!
Please send to [email protected]
We reserve the right to refuse adoption to anyone for any reason at any time. This questionnaire becomes part of our contract should an adoption be finalized. This application does not guarantee the adoption of any dog or necessarily hold your place in line. We can have multiple applications coming in at once on a dog. We do our best to keep everyone informed but occasionally a dog can be adopted before all our online listings can be updated or volunteers can communicate with one another. We ask that you do not get your heart set on a dog until final adoption papers are signed and they are home and adjusting well.
PET NAME / BREED / COLOR Applying For:
Name of applicant:
Occupation:
Names (and ages) of children, if any:
Address / Phone / Email:
Do you live in a House/Apartment/Condominium/ Town House/ Other _
Landlord’s Name and Phone Number:
Do you Own OR Rent?
If you rent, do you have your landlord’s permission to have a pet?
How much of the time will the dog be outdoors?
How much of the time will the dog be indoors?
About what percent of the time will the dog be left alone?
Where will it be when left alone?
What area(s) of the house will the dog be allowed into?
Where will the dog sleep at night?
Do you have a fenced yard? Yes or No?
Type of fence?
Are the gate(s) normally locked?
Do you have a pool? Yes or No?
If so, is it fenced separately from the yard? Yes or No?
Why do you want a dog?
House pet / Companion for family / Companion for other pet / Companion for children…
Other pets (specify number of each):
If you have any dogs or cats, are they spayed/neutered? Yes or No?
What pets have you had in the past?
What happened to the ones you no longer have?
What would happen to the dog if you moved?
Do you have a regular veterinarian?
If so, vet’s name/ clinic phone number?
Does anyone in your household have allergies to pets?
How would you train this dog? Have you Trained a dog/would you go to classes or get help if you had any training issues?
Will you be able to live with hair on your furniture, stains on your rugs, a warm body on your bed, and an animal that might be destructive at time?
Remember, pets are an investment of your time and money. Can you afford to provide medical care, home live, food, etc?
Are you able to make a long term commitment to care for your pet for its entire life span, which could be as much as 10-20years?
Under what circumstances would you not be able to keep this dog?
Signature & Date:
(If pasting this into an e-mail, type your full name and today's date for an e-signature)
[email protected] 717-712-8790
Completion of this application does not guarantee adoption of the animal.
INSTRUCTIONS: Please Note: Completion of this application does not guarantee adoption of the animal!! An application is required for anyone interested in adoption. Please remember this will not hold a dog! We do our best to hold a dog for the right adopter but can not guarantee adoption. To Fill Out & E-Mail: Copy and Paste the contents of this application into a new e-mail to us OR Scan the document OR print, fill out, and send us CLEAR pictures taken from your cell phone directly above this application showing everything as clearly as possible!
Please send to [email protected]
We reserve the right to refuse adoption to anyone for any reason at any time. This questionnaire becomes part of our contract should an adoption be finalized. This application does not guarantee the adoption of any dog or necessarily hold your place in line. We can have multiple applications coming in at once on a dog. We do our best to keep everyone informed but occasionally a dog can be adopted before all our online listings can be updated or volunteers can communicate with one another. We ask that you do not get your heart set on a dog until final adoption papers are signed and they are home and adjusting well.
PET NAME / BREED / COLOR Applying For:
Name of applicant:
Occupation:
Names (and ages) of children, if any:
Address / Phone / Email:
Do you live in a House/Apartment/Condominium/ Town House/ Other _
Landlord’s Name and Phone Number:
Do you Own OR Rent?
If you rent, do you have your landlord’s permission to have a pet?
How much of the time will the dog be outdoors?
How much of the time will the dog be indoors?
About what percent of the time will the dog be left alone?
Where will it be when left alone?
What area(s) of the house will the dog be allowed into?
Where will the dog sleep at night?
Do you have a fenced yard? Yes or No?
Type of fence?
Are the gate(s) normally locked?
Do you have a pool? Yes or No?
If so, is it fenced separately from the yard? Yes or No?
Why do you want a dog?
House pet / Companion for family / Companion for other pet / Companion for children…
Other pets (specify number of each):
If you have any dogs or cats, are they spayed/neutered? Yes or No?
What pets have you had in the past?
What happened to the ones you no longer have?
What would happen to the dog if you moved?
Do you have a regular veterinarian?
If so, vet’s name/ clinic phone number?
Does anyone in your household have allergies to pets?
How would you train this dog? Have you Trained a dog/would you go to classes or get help if you had any training issues?
Will you be able to live with hair on your furniture, stains on your rugs, a warm body on your bed, and an animal that might be destructive at time?
Remember, pets are an investment of your time and money. Can you afford to provide medical care, home live, food, etc?
Are you able to make a long term commitment to care for your pet for its entire life span, which could be as much as 10-20years?
Under what circumstances would you not be able to keep this dog?
Signature & Date:
(If pasting this into an e-mail, type your full name and today's date for an e-signature)
PET ADOPTION AGREEMENT
B LOVED RESCUE Adoption Contract
[email protected] 717-712-8790
Date of Adoption_______________________ Male / Female Spayed / Neutered
Breed/Type_____________________________ Apx Age___________ Name: ___________________
Vaccinations/Health Notes:________________________________________________________________
I_____________________________________________ ______________________________
Name / Address / Telephone
___________________________________________________________________________
AGREE: That I have been advised of upcoming and annual immunizations/medications that are necessary. I will provide annual veterinary checkups, keep immunizations current, and properly administer heartworm preventer (such as Interceptor or Heartguard) monthly or at least minimally from April through October. If the dog has any health issues I have been instructed how to care for them and what medications are/may be necessary. I understand that dog food provides a properly balanced diet and agree to feed the dog only a nutritious dog food, or snacks made just for dogs. I will keep fresh water available at all times. The dog will never be allowed to run loose unattended. The dog will be part of the family and be kept primarily in the house (particularly at night). When the dog is outside of the house, it will be kept either on a lead, in a fenced area (not a small, restrictive kennel unless it is being temporarily boarded), or on a trolley/chain/rope system. I agree not to strike the dog with my hand or any other object; I will learn to discipline the dog with my voice when necessary. If I have disciplinary problems with this dog, I will contact B LOVED RESCUE or a reputable professional dog trainer for advice. I will never allow my dog to be around young children without the supervision of an adult, or allow anyone to tease, squeeze too hard, “pick on” the dog, or “rough-house” to a point that could cause the dog become aggressive. Should I ever become incapable of keeping this dog in my care, I will contact B LOVED RESCUE before I place it elsewhere. I will not place it in a shelter or with someone else unless B LOVED RESCUE representatives agree or suggest a rescue type group. Any breech of this contract could result in the dog being reclaimed by any B LOVED RESCUE volunteers. If you are unable to keep the dog, it is not blending in well with your family and suggested changes have been tried (such as training assistance by a professional), you are responsible for returning the dog to B LOVED RESCUE. I understand B LOVED RESCUE is a volunteer group of dog loving individuals operating for the benefit of dogs and pets needing new homes. I agree to hold the group and its volunteers harmless in any injury or accident to anyone the pet may come in contact, whether or not in my care. Often these dogs are rescues and their history/behavior is not fully known at the time of adoption. You understand the risks involved. *Dogs/Cats must be spayed or neutered within 5 months to one year of age (or within 3 months of adoption if over one year of age) and proof of sterilization by a veterinarian must be provided to us via E-Mail or Fax.**50% Refund for Dogs Returned within 14 days – No refund after 14 day trial period.**B LOVED RESCUE is a volunteer group of dog lovers helping at-risk of euthanasia shelter pets make their way into loving homes. These pets have been observed for health & temperament to the best of our volunteers abilities. By signing this agreement you agree to all statements above.
SIGNED: (Representative of “B LOVED RESCUE”) __________________________________Date:
SIGNED: (Adoptee) __________________________________________________Date:
[email protected] 717-712-8790
Date of Adoption_______________________ Male / Female Spayed / Neutered
Breed/Type_____________________________ Apx Age___________ Name: ___________________
Vaccinations/Health Notes:________________________________________________________________
I_____________________________________________ ______________________________
Name / Address / Telephone
___________________________________________________________________________
AGREE: That I have been advised of upcoming and annual immunizations/medications that are necessary. I will provide annual veterinary checkups, keep immunizations current, and properly administer heartworm preventer (such as Interceptor or Heartguard) monthly or at least minimally from April through October. If the dog has any health issues I have been instructed how to care for them and what medications are/may be necessary. I understand that dog food provides a properly balanced diet and agree to feed the dog only a nutritious dog food, or snacks made just for dogs. I will keep fresh water available at all times. The dog will never be allowed to run loose unattended. The dog will be part of the family and be kept primarily in the house (particularly at night). When the dog is outside of the house, it will be kept either on a lead, in a fenced area (not a small, restrictive kennel unless it is being temporarily boarded), or on a trolley/chain/rope system. I agree not to strike the dog with my hand or any other object; I will learn to discipline the dog with my voice when necessary. If I have disciplinary problems with this dog, I will contact B LOVED RESCUE or a reputable professional dog trainer for advice. I will never allow my dog to be around young children without the supervision of an adult, or allow anyone to tease, squeeze too hard, “pick on” the dog, or “rough-house” to a point that could cause the dog become aggressive. Should I ever become incapable of keeping this dog in my care, I will contact B LOVED RESCUE before I place it elsewhere. I will not place it in a shelter or with someone else unless B LOVED RESCUE representatives agree or suggest a rescue type group. Any breech of this contract could result in the dog being reclaimed by any B LOVED RESCUE volunteers. If you are unable to keep the dog, it is not blending in well with your family and suggested changes have been tried (such as training assistance by a professional), you are responsible for returning the dog to B LOVED RESCUE. I understand B LOVED RESCUE is a volunteer group of dog loving individuals operating for the benefit of dogs and pets needing new homes. I agree to hold the group and its volunteers harmless in any injury or accident to anyone the pet may come in contact, whether or not in my care. Often these dogs are rescues and their history/behavior is not fully known at the time of adoption. You understand the risks involved. *Dogs/Cats must be spayed or neutered within 5 months to one year of age (or within 3 months of adoption if over one year of age) and proof of sterilization by a veterinarian must be provided to us via E-Mail or Fax.**50% Refund for Dogs Returned within 14 days – No refund after 14 day trial period.**B LOVED RESCUE is a volunteer group of dog lovers helping at-risk of euthanasia shelter pets make their way into loving homes. These pets have been observed for health & temperament to the best of our volunteers abilities. By signing this agreement you agree to all statements above.
SIGNED: (Representative of “B LOVED RESCUE”) __________________________________Date:
SIGNED: (Adoptee) __________________________________________________Date: