Promises Animal Rescue

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone*

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Thank you for your interest in adopting a dog from Promises Animal Rescue. Please tell us more about yourself and your family in the space below. Our casesworkers are looking forward to working you to help you find the best dog for you.

Please list the full name(s) of any additional applicant(s) in the box below.

Which animal are you interested in adopting?
Choose an animal: Maggie 2018-031 Midnight 2016-068 Regis 2022-003 Wolfie 2023-003 Xena 2022-001

How long have you lived at your provided address?*
Choose one: More than 1 year Less than 1 yea

If you lived at your current address for less than one year, what was your prior address?

Do you own or rent at the provided address?*
Choose one: Own Rent

If you rent, please provide your landlord NAME and PHONE NUMBER.

Please select the type of residence from the dropdown below.*
Choose one: Single-Family Townhouse Condo/Apartment Mobile home/RV

Have you or anyone in your home ever been investigated or convicted for animal neglect or cruelty?*
Choose one: Yes, myself or someone in my home has been investigated or convicted of animal cruelty No, myself or someone in my home has NOT been investigated or convicted of animal cruelty

Please select the number of dogs currently in your home from the dropdown.*
Choose one: 0 dogs 1 dog 2 dogs 3 or more dogs

Please select the number of cats in your home from the dropdown below.*
Choose one: 0 cats 1 cat 2 cats 3 or more cats

Are your pets spayed/neutered?*
Choose one: Yes No

What is your Veterinarian's NAME and PHONE NUMBER? (If you have pets or have had a pet within the past 5 years, this information is required)

What are the names of current pets or names of pets owned within the past 5 years?

Have you or any member in the household applied with any other rescue? If yes, please provide the organization's name and web address (ie. http://www.example.org).*

Approximately how long will the dog be home alone on an average day?*
Choose one: less than 3 hours 3 to 7 hours 7 to 9 hours 9+ hours

How many people, including you, live in your home?*
Choose one: 1 2 3 4 5 6 7 or more

Please list name, relationship, and age for each person in your house

What is the NAME, EMAIL and PHONE NUMBER of your 1st required personal reference? *

What is the NAME, EMAIL and PHONE NUMBER of your 2nd required personal reference? *

What is the NAME, EMAIL and PHONE NUMBER of your 3rd required personal reference?*

Thank you for taking the time to fill out this application. We will review the information you have provided. Once your references have been successfully checked, you will be scheduled for a home inspection. This is a chance to meet you, your family and current pets. All members of the household (including children and pets) need to be present for the home visit. Please contact your veterinarian and personal references to let them know we will be contacting them, so that they know they have your permission to talk to us.

We are pleased that you have shown interest to help save a dog with Promises Animal Rescue, Inc. We are always interested in comments and suggestions and are open to new ideas.

For questions/comments, please email: info@promisesanimalrescue.org .