Full Text
PRE-ADOPTION QUESTIONAIRE 815 Ironwood St N Jerome, ID 83338 (208)324-8436 LIKE US ON FACEBOOK @ Jerome Shelter ALL APPLICATIONS MUST MEET ADOPTION GUIDELINES. WE RESERVE THE RIGHT TO DENY ANY APPLICATION FOR ANY REASON. ALL DOGS WILL BE SPAYED AND NEUTERED BEFORE LEAVING THE SHELTER FACILITY. Question continue onto second page Date of Application: Name of Applicant: Email Address: Street Address: Mailing Address: Applicant: Home Phone: Place of Employment: Spouse: Name: Place of Employment: Age: Driver’s License: City/Zip: City/Zip: Cell Phone: Work Phone: Cell Phone: Work Phone: Below please describe what type of dog you are most interest in (temperament, trainability, energy, size): ☐ Puppy ☐ Dog Age: Sex: Breeds Preferred: Traits/temperament/size/trainability/energy/size: To ensure we are placing you and the animal you are interested in adopting is in the best interest of both the adopting party and the animal, please answer the following questions honestly and to the best of your abilities. 1. I am adopting this pet for: ☐ Myself ☐ Children ☐ Gift ☐ Other: 2. Who will be primarily responsible for the care, training, supervision, and overall welfare of the animal? 3. Do any of the household members have known allergies to dogs? ☐ Yes ☐ No 4. What will happen to this pet if you have to unexpectedly move? To ensure we are placing you and the animal you are interested in adopting is in the best interest of both the adopting party and the animal, please answer the following questions honestly and to the best of your abilities. ---PAGE BREAK--- Below is to be completed by shelter staff: Dog Impound # Approved: / Denied: / Shelter Staff Signature Date: 5. What will happen to pet when you go on vacation and/or if you have an emergency? 6. What activities do you plan on including your dog in? 7. Have you ever trained a pet before? ☐ Yes ☐ No 8. If yes, what kind of training methods do you use? 9. If no, what plan of action do you have to ensure the dog will be trained properly? 10. Do you have a regular Veterinarian? ☐ Yes ☐ No Name of Clinic/Veterinarian: 11. Please list current pets residing in your home: Type Breed Age Sex Indoor/Outdoor Spayed/Neutered ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No 12. Are your pets current on their vaccination? ☐ Yes ☐ No 13. Where will the dog sleep at night? 14. Where will the dog be when left alone? 15. How many hours will the dog be left alone daily? 16. Will you allow shelter staff do a home check? ☐ Yes ☐ No AM PM 17. Do you have a fenced yard? ☐ Yes ☐ No Fully Enclosed ☐ Yes ☐ No Partially enclosed ☐ Yes ☐ No 18. Height of fence: Type of Fence: 19. Type of home: Apartment ☐ Condo ☐ Duplex ☐ Mobile Home ☐ House ☐ Do you: Rent ☐ Own ☐ Please provide us with Landlord information if you rent (please note we will be contacting landlord to confirm you are allowed to have a dog living in the rental). Owner/Manager of Property: Phone#: 20. How long have you lived at this address? 21. Do you plan on moving in the near future? ☐ Yes ☐ No Signature of applicant(s) Date: SIGN