The Rescue Connection
27254 560th Ave, Austin, MN 55912 507 383 5631. the.rescue.connection13@gmail.com
Is there a particular animal you are applying for today?
Animal's Name
First Name:
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Last Name:
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Spouse/Partner First Name:
Spouse/Partner Last Name:
Street Address:
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No PO Boxes please
City:
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State:
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Zip:
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Phone#
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Alternative Phone#
Best Time to Call:
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Morning
Afternoon
Evening
Email Address:
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Occupation:
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How long at present job?
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If less than 1 year, how long at previous job?
References
List two personal references (no family members) who are familiar with your experiences as a pet owner. Please notify these people that we will be contacting them.
Reference #1 Name:
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CANNOT be related to you!
Relationship:
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Day Phone#:
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Evening Phone#
Best Time to Call:
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Morning
Evening
Email Address:
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Reference #2 Name:
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CANNOT be related to you!
Relationship:
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Day Phone#:
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Evening Phone#:
Best Time to Call:
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Morning
Evening
Email Address:
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Do you own or rent your home?
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Own
Rent
If Renting, do you have your landlord's permission to keep a dog?
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Yes
No
Not Applicable
Landlord's Name
First & Last
Landlord's Phone#:
NOTE: If renting, you will need to provide a copy of your lease/co-op bylaws to a representative of The Rescue Connection before adoption. Can you provide this?
Yes
No
Please check what best describes your home:
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House
Apartment
Condo
Trailer
Other
If 'Other' please describe
NOTE: If you live in a condo/co-op, or your house is part of a homeowner’s association, prior to adoption, you will need to provide a copy of the bylaws, rules and regulations of such association stating that there are no restrictions regarding owning a dog. If there is a limit on the number of pets you are allowed, please note the limit on the copy of the bylaws. Can you provide this?
Yes
No
How long have you lived at this address?
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If less than 1 year, please state how long at previous address:
Do you have a fenced yard?
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Yes
No
Fence Height:
In feet
Fence Type:
Wood, Chainlink, Vinyl, etc
Does the fence completely enclose the yard?
Yes
No
If no fence, please describe how you will handle the dog's exercise and toilet needs:
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Do you own a separate kennel run?
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Yes
No
If 'Yes', list height & size:
How many adults are in the home?
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How many children are in the home?
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Please list their ages:
Are all family members in agreement about adoptin a dog?
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Yes
No
Are there regular visitors to your home (human or animal) with whom your new dog must get along?
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Yes
No
If 'Yes' please describe:
Vet Information & Pets
NOTE: If you currently own a pet or have owned a pet in the last 10 years, your vet’s name is required to processyour application. If you cannot supply a vet reference, please give the reason why.
Do you own cats?
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Yes
No
If 'Yes', how many?
Are they all spayed/neutered?
Yes
No
If not fixed, why not?
Do you own dogs?
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Yes
No
'If 'Yes', how many?
Are they all spayed/neutered?
Yes
No
If not fixed, why not?
Please list the dogs/cats you currently own:
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Name, Age, Breed, Gender
Please list passed dogs/cats you have owned in the past 10 years
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Name, Breed & What happened to them
Are there other animals in the home?
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Yes
No
If 'Yes', please list them:
Name, Age, Species, Gender
Do you have a regular veterinarian?
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Yes
No
Name of Vet Clinic:
Vet Phone#:
Vet Street Address:
Vet City:
Vet State:
How long have you been with this vet?
If you cannot provide a veterinary reference, please explain why:
What are you plans for the dog you are adopting? Check all that apply.
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Pet
Watch/Guard
Hunting
Obedience
Herding
Agility
Other
Where will this dog spend the day?
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Loose Indoors
Crated Indoors
Basement
Garage
Fenced Yard
Outdoor Kennel
Other
If you selected 'Other', you must explain in detail.
On average, how many hours per day will this dog be without Human company?
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Where will this dog spend the night?
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Loose Indoors
Crated Indoors
Basement
Garage
Fenced Yard
Outdoor Kennel
Other
If you seleted 'Other' you must explain in detail
Do you understand that The Rescue Connection requires this dog to be spayed/neutered?
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Yes
No
Do you agree to license this dog and give it regular health care?
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Yes
No
Do you agree to return the dog to The Rescue Connection if you can no longer keep it?
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Yes
No
Would you be willing to allow someone designated by The Rescue Connection to visit your home by appointment?
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Yes
No
If 'No', why not?
How did you hear about The Rescue Connection?
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Are you 18 years of age or older?
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Yes
No
If under 18 yo, are your parents agreeable to you adopting this dog?
Yes
No
Is there anything else you would like to tell us?
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ELECTRONIC SIGNATURE:
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I hereby agree all information I've provided is true
DATE:
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Please make sure you have completed this form in full. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED!
Submit
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