Pinealope Animal Rescue 

Where every life counts

Adoption/Foster Application

We spend a lot of time reviewing applications so please be thorough when filling in the blanks.  Applications half answered will not be responded to.

Date
Do you want to foster or Adopt?
Email
List the number of children in the home and their ages (17 & younger)
Where did you hear about us
Length of time with current vet
Are you a first time Dog owner
Do you Rent or Own? How long have you lived at this address? If renting provide, Company name & number of Landlord
Where will the new dog be allowed in the home? (run of house, kitchen, living room, etc.)
Type of Housing? (house, duplex, mobile, apartment, etc.)
How many dogs and cats do you have now
Do you have experience with this breed of dog? IF YES EXPLAIN
Are current pets UTD on shots, spayed/neutered & on prevention? If no Explain
How will you confine this dog while outside? (fence (include height), leash, kennel, etc.)
Do you have any experience with house/crate training, Chewing, Biting, Sep. anxiety, obedience? If yes explain
What brand / type of food will this dog eat
Your employer, including name, number and your position
Name of dog applying for
Your spouse's employer, including name, number and your position
Name, number of current veterinarian
List names/ages of all Adults in the home (18 & older)
How many dogs and cats have you had in the past 7 years
List each current dog and cat including their breed and ages
List 3 references including their contact number (co-worker, neighbor, friend, previous org. adopted from)
Electronic Signature of Applicant
COMPLETE Physical Address (INCLUDING CITY, SATE AND ZIP CODE)
Phone Number/s
Name of person applying
Submit