SANDY PAWS RESCUE ADOPTION APPLICATION



The answers you give on this application assist us in finding the best possible match between you and the dog we have available. Please fill out the form completely and return it by fax @ 406-323-1863 or by snail mail - Sandy Church ~ 225 Canyon Road ~ Roundup, Montana 59072.

Name _________________________________________Home phone________________

Address _______________________________________Work phone_________________

City _________________________ State _______________ Postal Code______________

Best time to call __________________________________________________________

Occupation ______________________________________________________________

Personal reference: Name___________________________________________________

Relationship ______________________________________________________________

Phone________________________________ Do you own or rent your home? ________

If rent, do you have landlord's permission to keep a dog? ___________________

Landlord's name and phone number? ___________________________________________

Do you live in (circle) * house * apartment * trailer * other *

Describe __________________________________________________________________

Do you have a fenced yard? _________ Fence height & type _________________________

Does fencing completely enclose a yard for dog? _________________________________

If no fence, how will you handle dog's exercise and toilet duties? ______________________

Do you have a separate kennel run? ___________ Height and size_____________________

How many adults in household? __________ How many children?________

Age and sex of children? _____________________________________________________

Are there regular visitors to your home, human or animal, with which your new dog must get

along? Describe___________________________________________________________

Do you own other dogs? ___________ Are they neutered?_______________

Give breed, sex and age of each: ________________________________________________

__________________________________________________________________________

Do you own cats? ________ How many? _______

Any other animals you own? ______________________

Do you have a regular veterinarian? (Circle) * Yes * No *

Name?___________________________________________________________________

Address and phone____________________________________________

How many dogs have you owned in the last five years? ___________________________

If any of your dogs have perished in the last five years, what happened to dog (be specific)

________________________________________________________________________

What breed are you hoping to adopt?____________________________________________

Why did you choose this breed? _______________________________________________

List all plans for this dog (circle) pet * guard * hunting & obedience * search & rescue * other

If other, please describe _____________________________________________________

Do you want to adopt (circle) * Male * Female * No Preference *

Where will the dog spend the day? (Circle what applies) *Loose indoors * Crate * Basement *

Garage * Fenced Yard * Loose outdoors * Tied up outside * Kennel run * other *

Describe __________________________________________________________________

How many hours, on average, will dog spend alone? _______________________________

Where will dog spend the night? (Circle what applies) Loose Indoors *Crate * Basement *

Garage * Fenced Yard * Loose Outdoors * Kennel run * Tied up outside * other *
Describe ________________________________________________________________

Do you agree to license this dog and give regular health care? ______________________

Do you agree to contact Sandy Paws Rescue if you can no longer keep this dog? _______



Sandy Paws does not charge for docgs placed in new homes, other than to recover our vet expenses. Actual adoption costs will vary for each dog. All of the information I have given above is true and complete. This dog will reside in my home as a pet. I will provide it with adequate food, water, shelter, training, affection and medical care. I understand that Sandy Paws is a referral service and is not responsible for the accuracy of information received about the temperament, habits or physical condition of dogs available for adoption. I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adopt it. I am in full agreement with these terms of adoption. Sandy Paws Rescue is in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog into my household.



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Applicants Signature


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Date Signed

Sandy Paws Rescue reserves the right to refuse any applicant!