Adoption Application

P.O. Box 1574, Midlothian, VA 23113-1574

Phone: (804) 417-7527

info@labrescue-richmond.com

Personal Information

Applicant's First Name: *

Applicant's Last Name: *

Applicant's Age: *

Applicant's Phone Number: *

Applicant's E-mail: *

Applicant's Employer: *

Applicant's Position/Title:

Applicant's Work Number: *

Average number of days applicant is out of town for business and/or pleasure: *

times a *

I am the sole applicant *

Yes No

Co-Applicant's First Name:

Co-Applicant's Last Name:

Co-Applicant's Age:

Co-Applicant's Phone Number:

Co-Applicant's E-mail:

Co-Applicant's Employer:

Co-Applicant's Position/Title:

Co-Applicant's Work Number:

Average number of days Co-applicant is out of town for business and/or pleasure:

times a

Co-Applicant's Relationship to Applicant

Spouse/Partner Parent/Guardian Child of Applicant Roommate

Address: *

City: *

State: *

Zip: *

Household Information

Type of Dwelling: *

Do You Own or Rent *

Own Rent

Describe Household

Active Quiet Noisy Average

If You Rent..

An executed copy of your full lease agreement must accompany your application.

Lease Agreement

Have you received permission from your landlord to have a dog?

Yes No

Is there a weight limit on dogs in your rental property?

Yes No Unsure

What is the limit?

Is your yard fenced, Physical or Invisible? *

Yes No We do not have a yard

Describe the type/style of fence:

Please include material and height

Height of fence

6ft 5ft 4ft Other

Are there any gaps or low areas in the fence?

Yes No

Are you currently expecting a child? *

Yes No

Are you considering having and/or adopting children within the next 10 years? *

Yes No Undecided

List all of the residents of your household other than applicant

and co-applicant.

Residents:

Is anyone home during the day? *

Yes No

Who?

On a typical work day. how many hours will the dog be left alone?

In order to find the perfect match for your family, it helps us to know if anyone in the household uses devices such as walkers, wheelchairs, scooters...

General Questions

Has the applicant or co-applicant applied to adopt from Lab Rescue before?

Applicant *

Yes No

Co-Applicant

Yes No

What was the outcome of your application?

What was the dogs' name?

Date of adoption:

- Month - Day Year

Name of your adoption coordinator:

Who will be responsible for the dog? *

Why do you want a Labrador Retriever? *

How will your dog be cared for when the responsible persons are out of town? *

All dogs adopted from Lab Rescue will be spayed or neutered. Do you have any reservations or questions about this? *

Yes No

Please Explain:

Please be thorough and use multiple sentences for the following section.

Where will the dog be kept during the day? *

Where will the dog be kept during the night? *

Plans for crate use: *

How much do you think it will cost to take care of your dog each year (food, vet care, license, toys, supplies, training)? *

How do you plan to exercise your lab? *

Pet Care Experience

Have you ever owned a dog before? *

Yes No

Was your experience as a/an

Adult Child Both

Have you ever house-trained a dog before? *

Yes No

Please Explain your house training methods:

Have you ever crate-trained a dog? *

Yes No

Have you ever obedience trained a dog before? *

Yes No

Did you do so on your own or with a professional trainer?

How would you train a dog to walk on a leash? *

How would you deter jumping? *

How would you work with a timid/shy dog? *

How would you handle a dog that play bites (mouthy)? *

Explain how meal times would be handled with multiple dogs. *

If you saw your dog doing something she or he shouldn't, how would you respond? *

Please list all pets that you have owned in the past five (5) years:

Pets:

Have you ever had a pet die at an early age due to an accident? *

Yes No

Please give details:

Have you ever given a pet away or turned a pet over to a shelter or rescue group? (This includes animals adopted from and then returned to a shelter or rescue group.) Or pets given to a family member. *

Yes No

Please give details:

Characteristics of Labrador Retriever You Hope To Adopt

Sex? *

Color? *

Chocolate Yellow Black No Preference

Age? *

I have NO Age Preference I have an age PREFERENCE I have an age REQUIREMENT

Age

Would you consider adopting a dog over the age of 3 years? *

Yes No

Would you consider adopting a dog over the age of 7 years? *

Yes No

Would you consider a Lab/Mix? *

Would you consider" Fostering to Adopt" ? *

Energy Level: *

High (dog will need plenty of aerobic exercise daily such as jogging, swimming, dog-dog play, or retrieving) Moderate (dog will need at least two walks daily plus some play indoors or in a fenced yard) Couch potato (dog will be happy with a couple of leisurely strolls or visits to a fenced yard daily)

Is energy level a *

Requirement Preference

*Please note that it is rare to find a Labrador retriever who is a couch potato unless he or she is beyond middle age. Healthy adult dogs should have at least 30 minutes of aerobic activity daily, but many Labs require more than that.

Please tell us if there are any other qualities that you are looking for in your Lab:

Veterinarian Reference: Please provide the contact information for the Vet clinic(s) that can verify the vaccination and spay/neuter status of all dogs and cats you currently or have owned within the last 5 years.

I have spoken to my vet and given them permission to speak with Lab Rescue.

Yes

Veterinarian:

References

Please provide the names and phone numbers of two references. (Neighbors, friends, family, etc.)

One reference must notbe a family member or live with you.

Name: *

Phone Number: *

Name: *

Phone Number: *

How did you hear about Lab Rescue of Greater Richmond?

If you have additional information to add to this application, please enter it here:

I have read the adoption process and *

I Agree

Before submitting your application, please print it so that you have a permanent record. If you attend an adoption day before you have been contacted by an adoption coordinator, you will need to bring a printed copy of your application.

By submitting this electronic application, I acknowledge that all the information on this form is true and correct. I understand that any misrepresentation of fact may result in the removal of the adopted dog from my home by Lab Rescue. *

I Agree

By submitting this electronic application, I certify that I have never been convicted of animal cruelty, neglect or abandonment. *

I Agree

Enter the message as it's shown *