Tazzy Animal Rescue Fund

Website Developed and Maintained by Website to the Rescue

Dog Adoption Application

We are glad you would like to adopt a new pet from us. The following information is required so that we can assist you in the selection of your new pet. This form and consultation with a Tazzy Animal Rescue Fund representative is designed to help us determine if the adoption is in the animal’s best interest, and to assist you in finding the animal most compatible with your lifestyle.

Our Adoption Fees are as follows:
Adoption Fees range between $95 - $400 and are based upon breed (pure or mixed), age, health, socialization (i.e. good with dogs, cats and kids)

Your donation is a tax deductible expense and it goes toward funding our rescue efforts.

Our Rescue Retirement Program is designed to place our older dogs into homes where the adopter is home more often than not; therefore Tazzy Fund WAIVES the $95 donation for our dogs aged 8 and up when the adopter is a Senior Citizen, aged 55 years or older.

Tazzy Fund is a 100% volunteer run rescue and we do not have a shelter location for our dogs. All of our dogs live in the foster homes of our volunteers, so that we can assess them in a normal living environment. We do require an adoption application be completed and a home check approved prior to scheduling introductions with our adoptable pets.

Name of Dog you are applying for:
Name of Second Choice Dog
Name of Third Choice Dog
Why do you want to adopt this dog? (Check all that applies)	Companion Companion for another pet House Pet Watch Dog Guard Dog Hunting

PERSONAL AND HOUSEHOLD INFORMATION

Applicant Name:
Date of Birth:
Co-Applicant (if applicable)
Date of Birth:
Street Address:
City, State, Zip:
Email Address
Home Phone
Cell Phone

What is your occupation?
How long have you been at your current job?
Employer:
Work Phone:
Work Address:
Work City, State, Zip:

Who shares your household? (Check all that applies)	Spouse Significant Other Children Roommate Live Alone
If you have children, what are their ages?

If your present relationship were to change, with whom will the dog remain?
At what age do you feel children are responsible enough to care for a dog without assistance (ie walk, feed, scoop, etc.)?
Does anyone in your household have allergies to animals?
If Yes, how will this be managed?
Are you planning on moving in the next 12 months?
Is so, where?

What type of home do you live in?	If other, explain:
Do you own or rent?
If you rent, do you have written permission to have animals in your home?
If you rent, please provide your landlord's name and phone number	Name: Phone:
If you rent, do you share your yard with any other tenants?
Do you have a completely fenced yard?
What type of fence?	If other, please explain:
What is the height of your fence (at the lowest point)?
Which of the following is used to secure your gate: (Check all that applies)	Latch Keylock Deadbolt Padlock Do not lock the gate because:
Do you have a gardener, house keeper or pool cleaner?
If yes, where will the dog be while they are working?
Do you trust the workers not to let the dog out?	Explain:
Do you have any poisons (rat, mouse, or snail bait) where the animal will be kept?
Is someone home during the day?	If yes, who?

PET CARE AND OWNERSHIP

How many hours will the dog be alone during the day?
If you work full time away from home, what are your plans for the dog during that time away?
Which rooms, if any, are off limits to dogs?
Will the dog be allowed on the furniture?
Will you exercise your dog on a regular basis?
What exercise method and how often?
Where will the dog be kept during the day?
Where will the dog be kept during the night?
When you go on vacation, who will care for the dog? (Check all that applies)	House Sitter Veterinarian Kennel Friend's House Pet Sitter / Friend comes by to feed but doesn't stay Dogs goes on vacation with me/us Other: Explain
Will you keep the dog's vaccinations up to date?
What type of food will you feed your dog?
How many times per day will you feed your dog?
Who will be responsible for feeding your dog?

Would this be your first pet?
Do you currently have any pets?
If Yes, please provide the following information:

Current Pet 1:
	Type of Pet (Dog, Cat, Bird, etc.)
	Breed
	Age
	Gender
	Neutered/Spayed
	Current on Vaccinations
	How do you feel this pet will adjust to a new animal?

Current Pet 2:
	Type of Pet (Dog, Cat, Bird, etc.)
	Breed
	Age
	Gender
	Neutered/Spayed
	Current on Vaccinations
	How do you feel this pet will adjust to a new animal?

Current Pet 3:
	Type of Pet (Dog, Cat, Bird, etc.)
	Breed
	Age
	Gender
	Neutered/Spayed
	Current on Vaccinations
	How do you feel this pet will adjust to a new animal?

Current Pet 4:
	Type of Pet (Dog, Cat, Bird, etc.)
	Breed
	Age
	Gender
	Neutered/Spayed
	Current on Vaccinations
	How do you feel this pet will adjust to a new animal?

Have you owned any pets in the past?
If Yes, please provide the following information:

Past Pet 1:
	Type of Pet (Dog, Cat, Bird, etc.)
	Breed
	Age
	Gender
	Neutered/Spayed
	How long did you own this pet?
	What happened to this pet?
	If died, please explain:

Past Pet 2:
	Type of Pet (Dog, Cat, Bird, etc.)
	Breed
	Age
	Gender
	Neutered/Spayed
	How long did you own this pet?
	What happened to this pet?
	If died, please explain:

Past Pet 3:
	Type of Pet (Dog, Cat, Bird, etc.)
	Breed
	Age
	Gender
	Neutered/Spayed
	How long did you own this pet?
	What happened to this pet?
	If died, please explain:

Past Pet 4:
	Type of Pet (Dog, Cat, Bird, etc.)
	Breed
	Age
	Gender
	Neutered/Spayed
	How long did you own this pet?
	What happened to this pet?
	If died, please explain:

Which of the following would force you to give up your dog?	Divorce / Separation	Move out of State
(Check all that applies)	Move where pets are not allowed	Dog barks a lot
	Dog nips at strangers	Dog bites children
	Marry someone with allergies	Dog loses control of bladder
	Dog develops chronic illness	Large Vet bills
	Dog is untrainable	Dog is not the kind of dog I thought it would be
	Planning on having a baby	Just gave birth to a baby
	Dog doesn't get along with current pet	Neighbors complain about pet
	Other: Explain:	Would never give up a pet

Do you currently have a veterinarian?
If Yes, please provide us with your vet/clinic's Name and Phone Number	Name: Phone:
Are you prepared to cover any vet expenses you pet may incur throughout it's lifetime?
Is there a limit?
How much is too much?
Would you consider euthanizing your pet because of medical costs?
What do you think is the best way to keep your animal's teeth clean? (Check all that applies)	Clean them myself Never thought about it Have a professional clean them It's not necessary
Which of the following would you use for flea control? (Check all that applies)	Flea Spray Flea Bath Flea Collar Herbal Flea Collar Flea Busters Flea Comb Program, Advantage or Frontline
What is a behavior that would not be acceptable to you?
What method of discipline will you use if your dog chews up your favorite shoes? (Check all that applies)	Swat nose Spank with hand Spank fanny with newspaper Stern voice Scruffing Other: Explain
If necessary, would you be willing to hire a trainer or take your dog to obedience classes?
What method do you intend to use to housetrain your dog?
In which of the following situations would you allow your dog off leash? (Check all that applies)	Public Park Hike Beach Neighborhood Walk My front yard Dog Park Other: Explain
If you become ill or die, what plans will you make for the care of your pet?

Please provide us with 2 personal references:
Personal Reference 1 Name and Phone	Name: Phone:
Personal Reference 2 Name and Phone	Name: Phone:

Are you willing to have a representative from Tazzy Animal Rescue Fund come to see where the pet will be living?
If no, why?
How did you hear about Tazzy Animal Rescue Fund?
Have you applied to adopt an animal from us in the past?
Have you applied to adopt an animal from another rescue group?
If so, what happened?

Would you like to be added to our mailing list?

Do you have any comments or additional information that you feel is necessary in consideration for adopting this dog?

I understand that filling out this application does not guarantee the adoption from Tazzy Animal Rescue Fund. I certify that all of the above information is honest and true.

To validate human entry of this form, please answer the following question:

How many dogs are in the picture below? One, Two or Three?

If you are unable to submit this online application, or would prefer to fill it in by hand, click here to download this application in PDF format. You will need Adobe Reader to open this attached form.