L&S Dog Diggity Adoption ApplicationPage 1 of 7InstructionsHi, and thank you for your interest in adopting a rescue dog! The first step in this process is to fill out the following application and submit it If you have any problems with the form or any questions, please contact Ellen at gingerdog@live.com for immediate assistance. Please take a moment to gather information before starting because you will not be able to save your information if you have to stop before the application is completed. You will need vet name and number, 2 reference names and numbers, and if you rent you will need your landlord's name and number. Our adoption coordinator will review your application and schedule a time to talk with you and arrange a home visit. Let's get started! Dog's NameEnter the name of the dog you are most interested in adopting. If not known put 'Unknown'. You can provide additional details as needed in the next answer.What else would you like us to know about the dog you'd like to adopt?*Tell us why adopting is important to you and about your experience with dogs*NextAbout YouEnter Full Legal Name (First Middle Last)*Other Names UsedEmail address*Occupation/Employer*Age*Street Number/Name*City*State*Zip*Home*CellWorkContact Required to progressIf we cannot reach you by phone, text and/or email your application will not progress. Check your voice mail and email junk box. BackNextAbout Your HouseholdIs a spouse or partner living with you?*YESNoYour Spouse/PartnerNameFirstLastEmail addressHomeOccupation/EmployerCellAgeWorkAre other adults living with you?YESNoPlease list all adults living in the homeName, Email, PhoneCommentsName, Email, PhoneCommentsName, Email, PhoneCommentsAre there any children living with you?*YESNoPlease list all agesAre there any other dogs living with you?YESNoNameBreedAgeGenderPlease selectMaleFemaleSpayed/Neutered?Please selectYESNONameBreedAgeGenderPlease selectMaleFemaleSpayed/Neutered?Please selectYESNOCommentsCommentsPlease tell us about any other dogs living with you, and about how you expect your dogs to respond to a new dog.Are there other pets living with you?*YESNoNameType (cat, bird, etc) / BreedAgeGenderPlease selectMaleFemaleSpayed/Neutered?Please selectYESNONameType (cat, bird, etc) / BreedAgeGenderPlease selectMaleFemaleSpayed/Neutered?Please selectYESNONameType (cat, bird, etc) / BreedAgeGenderPlease selectMaleFemaleSpayed/Neutered?Please selectYESNOCommentsCommentsPlease tell us about any other pets living with you, and about how your expect your pets to respond to a new dog.Is anyone in your home allergic to pets?*YESNoPlease describe the severity and what steps you plan to takeBackNextLiving SituationDo you...*Own your homeOwn a condoRent your homeRent an apartment/condoDo you pay a pet deposit?*Please email proof that you can have a dog/puppy at your rental to: gingerdog@live.comLandlord's Name*Landlord's Phone Number*Does your home have a fenced yard?*YesNoHow long have you lived here?*Fence Location*FrontBackBothFence Height*Type of Fence*Chain inkPrivacy (e.g. cedar)OtherPlease describe fenceUpload pictures of fence/yard (1 MB max)Describe conditions (acreage, near a lake or parks; someone always home; etc)*Are there any breed specific regulations in place where you live?*YESNOI DON"T KNOWWhat are they?Have you ever had to surrender or re-home a dog?*YESNOWhat were the circumstances?BackNextAccomodationsHow long will the dog be left alone?*0 - 2 hours2 - 4 hours4 - 8 hoursOver 8 hoursIf the dog will be alone for more than 4 hours a day do you plan on using dog walker or day care services?*Where will the dog stay in the day?*InsideOutsideBothWhat do you have for the dogs comfort when staying outside?Where will the dog stay at night?*InsideOutsideBothWhere will the dog sleep inside?*Someones bedStand alone dog bedCrateSeparate roomWho will be responsible for exercising the dog?Please check which traits are important to youKid friendlyDog friendlyTolerant of catsMaleFemaleSubmissive to other dogsWhat types of training do you feel comfortable withHousebreakingBasic obedienceSocialization - dogsSocialization - kidsSocialization - catsResource guardingMouthing/nippingWhich size dogs can you work with?Small < 25 lbsMedium 25 - 50 lbsLarge 50 - 75 ;bsExtra large > 75 lbsAnything else we should know about finding the right match for you?BackNextReferencesAre your pets medications/vaccinations current?YESNOSOMEDo you have now or have you had (in the last few years) a vet who will provide a reference?YESNOPlease give the vet's office permission to speak with us *Hospital / Vet NameLocation*Phone Number*You must enter two references for your application to be accepted. Name*PERSONAL REFERENCE 1Relationship*Phone Number*Name*One reference must not be a family memberPERSONAL REFERENCE 2Relationship*Phone Number*BackNextAdoption AgreementDO YOU AGREE?*YESNOPlease select 'YES' next to each item to indicate your agreementI / we agree to take this dog to the vet within 30 days of adoption for a check up.DO YOU AGREE?*YESNOI / we understand that this is a rescued animal and although we do our best to determine the temperament and current health status of the animal there is no guarantee on health or temperament.DO YOU AGREE?*YESNODO YOU AGREE?*YESNOI / we agree that if we choose to surrender this dog back to L&S Dog Diggity, we will foster the dog until a home can be found. If we cannot foster and there is no other foster available we will board the dog until adopted, and boarding fees will be deducted from the adoption fee refund.I / we authorize L&S Dog Diggity to perform a background check.DO YOU AGREE?*YESNOI / we agree to complete age appropriate immunizations for this dog as needed and to maintain appropriate immunizations for its entire life.DO YOU AGREE?*YESNOI / we agree to allow a rescue representative to visit your home prior to the adoption and to make a follow-up visit to your home within 4 weeks,DO YOU AGREE?*YESNOI / we agree that if the dog needs to be re-homed or we can no longer keep it for any reason, we will return the dog to the adoption liaison point of contact and notify Sue St. Cyr (sue@dogdiggityrescue.com). We will not take the dog to a shelter, rescue, to re-home the dog without WRITTEN advance approval.You are agreeing to these terms by printing your name and date below.*BackSendThis field should be left blank
