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	Online Adoption Application Please thoroughly complete the application, reading all terms and requirements. When you are done, click SUBMIT. Do NOT send this application as it will be DISCARDED (NO exceptions!) if: You do not currently or have not in the recent past owned a dog and therefore: You do not have vet records in your name for us to verify. We MUST talk to your vet about the care you gave previous or current dogs You have not spayed or neutered your dogs, they are not up to date on all shots and/or you do not use heartworm preventative. You currently own a LARGE aggressive DOG or have a child under age 5, both of whom can injure a small dog You have an invisible fence, which requires a shock collar SOS DOGS is dedicated to the care of tiny helpless dogs and to placing them in loving homes with experienced and compatible owners. An incorrect placement may mean the dog once again ends up in rescue. Therefore, please take a few minutes to fill out this questionnaire. Although it may seem very extensive, our goal is to make each adoption a rewarding experience for you and your new pet. This questionnaire helps us to place our little babies quickly and correctly, meeting everyone's needs. SOS DOGS reserve the right to refuse any application. Name of dog for which you are applying: Personal Information Applicant Last Name (must be over 25) Applicant First Name Co-applicant Last Name (spouse, etc., 25+) Co-applicant First Name Email Address (must have email address, if it changes advise us immediately) Home Address City State AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WV WI WY Zip Home Phone Work Phone Fax Cell Phone Applicant Age Occupation Co-Applicant Age Co-Applicant Occupation We DO NOT ship dogs. You must be willing to drive to NJ or surrounding state to get the dog. If acceptable, please initial: Household Information Type of Residence Single Home Row home Farm/Rural home Duplex Condominium Townhouse Twin Do You? Own your home Rent your home Type of Area Urban Suburban Rural How big is your yard (square feet) How big is your house (square feet) Do you have a completely fenced area? Yes No How tall and what type is the fence? How big is the fenced area? (square feet) Do you feel your fence is secure enough to secure a small dog from going under or through? Yes No If you do not have a fenced yard, please tell us how you plan to provide exercise and elimination: If Name, Landlord Name (if renting) Landlord Phone Years in current residence Years in previous home Do you own a pool or hot tub? Yes No Is it fenced in so the dog can't fall in? Yes No May we do a home inspection? Yes No When is the best time? Days Weekends Evenings People Who Live In Your Household Note: We do NOT adopt to anyone with children under the age of 5. Name Age Relationship to Applicant All adults work full-time? Yes No Part-time? Yes No IF YES: Hours Days Does your job require travel? Yes No How often? Are you subject to relocation? Yes No Is anyone home while you work? Yes No Who? Dog Care Information TOTAL hours a day will the dog be alone Day Hours Evening hours If you work an 8 hour day, what provisions will be made for the dog's ability to eliminate during this time? (e.g. do you come home for lunch, have a dog walker, use pads, etc?) Where will the dog be kept during the day? Loose indoors Crate Basement Dog Room Laundry Room Bathroom Kitchen Other confined room Fenced yard Chained outside Fenced dog area Outside Kennel Run Loose outdoors Garage Radio/Electric Fenced Yard On lead attached to house/tree, etc Other Where will the dog sleep at night? Loose indoors Crate Basement Dog Room Laundry Room Bathroom Kitchen Other confined room Fenced yard Chained outside Fenced dog area Outside Kennel Run Garage In bed with us In bed with a child On lead attached to house In bedroom on floor Other Who will be responsible for housebreaking, feeding, training, grooming? How many years experience does this person have in dog training, etc? Who will take care of the dog if you are unable (ill, vacation, etc)? Animals are as individual as people. How much time will you allow this dog to adjust to your homes and life? Under what circumstances would you not keep the dog? Please tell us how you would housebreak a dog, including what PREVENTATIVE measures you would use: Pet History It has been our experience that potential adopters who have never owned pets before are not prepared for the problems that may occur with a rescue dog and return the dog, causing unnecessary trauma. Therefore, we do NOT adopt to anyone who has not had an dog before and/or who does not have a good recent verifiable vet record to confirm its care -- NO EXCEPTIONS!!!!! Please tell us what happened to any previous pets Do you understand that a new dog may not immediately "get along" with other animals or family members? How do you plan to help this process? Have you ever had an animal die at an early age? Yes No Explain Have you ever given an animal to a shelter or rescue? Yes No Explain Have you ever had a rescue animal before? Yes No Explain Current Pets In Your Household Pet 1 Type Breed Name Sex M F Age Weight Years Owned Spayed/Neutered Yes No Obtained From Shots Current Yes No Heartworm Preventative? / Type No Yes: Pet 2 Type Breed Name Sex M F Age Weight Years Owned Spayed/Neutered Yes No Obtained From Shots Current Yes No Heartworm Preventative? / Type No Yes: Pet 3 Type Breed Name Sex M F Age Weight Years Owned Spayed/Neutered Yes No Obtained From Shots Current Yes No Heartworm Preventative? / Type No Yes: Pet 4 Type Breed Name Sex M F Age Weight Years Owned Spayed/Neutered Yes No Obtained From Shots Current Yes No Heartworm Preventative? / Type No Yes: Additional Pet Information: (list any other pet information here) Are your dogs either submissive or aggressive? What do you feed your dogs? Dog Wanted Breed Preferred Yorkie Bichon/Poodle Maltese Westie Any small dog Sex Preferred Male Female   Please note males are MUCH more available than femailes Oldest Acceptable Age: Years Will take a small dog of any age Will you accept a dog who has been abused (but does NOT bite). Yes No Will you accept a dog who has treatable medical problems (i.e., pills). Yes No Will you accept a dog who needs some housebreaking help? Yes No Does anyone in your house have allergies to pets Please note bichons and poodles are known as hypo-allergenic; others are non-shedding and often do not cause allergies. Yes No Affordability What do you anticipate spending yearly for vet care for this animal? $ If you adopted a dog and it developed a costly medical problem ($2000+) that was correctable, what would you do? Are you willing and CAN YOU AFFORD to deal with potential medical problems, emergencies and/or special needs should they occur during the span of the dogs' life? Yes No References Please provide reference information of NEIGHBORS ONLY (not friends) who may be contacted as part of the approval process. Name of neighbor to the right Phone / email Name of neighbor to the left Phone / email Applicant's Employer (Name, phone / email Co-Applicant's Employer (Name, phone / email) Groomer you have used with your pets (Name, phone / email VET REFERENCES: PLEASE READ THIS: DO NOT send this application if you do not have a vet who you have used for your previous or current dog OR there are no records available for us to verify in YOUR NAME. Please call your vet to make sure they are available if your dog has died or it has been more than a year since you've had a dog. We MUST be able to call and speak to your vet and discuss your history. If records are not available at the vet's, you may send copies of your last few years of vet bills to show care given. If you send this when you have no vet history, your application will be discarded - NO EXCEPTIONS!!!!!!! Vet records current or available? Yes No I am emailing copies of my records Yes No Name of vet office Doctor's name Phone # of vet office Date of last visit Email of vet office Reason for last visit City, State of vet office Additional Comments Any Other Vets Used And Contact Information Please list any memberships in Humane Societies, organizations or clubs related to dogs and/or training or any related volunteer work: Some Considerations Before Adopting Do you understand and accept that this may be a 15 year commitment (life of a small dog), which means if you retire, want to travel, you have to consider the dog and cannot just dump it? Yes No If you are a senior citizen, do you have someone who will care for the dog when you no longer can? You might consider making provisions for the care of your dog(s) in your will so they don't end up in a shelter. Yes No NA Have you considered and accepted the expense of an annual vet check-up and vaccinations, vet care in case of emergencies or illness, annual teeth cleaning, monthly heartworm preventative, flea and tic preventative, grooming, dog food, etc.? (several hundred a year) Yes No Have you considered and accepted that if you currently rent and move, you must find another rental that permits pets? Not all rentals permit animals and it will limit your choice of rentals? Yes No NA Are you aware that the adults must adopt a dog and be responsible for it? A pet cannot be adopted "for the children" and then no longer be kept when the children lose interest. Is this acceptable to you? Yes No NA Are there any children in your household who could open a door to go out and inadvertently let a dog run out? If yes, please answer the next two: Yes No Are you willing to teach your children to accept the additional responsibility, care and humane treatment of a pet? Yes No Are you willing to supervise your children to be certain they do not harm a small, helpless animal? Yes No Would you consider volunteering to help SOS DOGS? Yes No If Yes, in which of the following areas? Fostering dogs Transportation of dogs Checking prospective homes In what towns, geographic areas or states will you help? Adoption Process  When you adopt a dog through us, you will be asked to sign an Adoption Contract. CONTRACT: This contract specifies, among other things, that the dog: will receive proper specified home and vet medical care, including an annual exam and shots, monthly heartworm preventative given year round, etc.; will be licensed and identified; will always be on a leash or in a fenced yard; will never be taken to a shelter or given away; will not be used for anything other than a family pet; will live indoors; will not be chained; you will contact this rescue if you can no longer keep the dog so we can find a new home; and it allows for us to contact you for verification of the dog's welfare. There is also a release statement. ADOPTION FEES are based on age and include all medical being done (except when not advisable due to age, etc.). The fee is based on age, not on our medical expenses, so a dog who costs us $5,000 in medical or a dog who costs us nothing have an equal chances of being adopted. SOS DOGS is a 501c3 non-profit organization. Please realize that dogs need vet care throughout their lives, including yearly exams and boosters, monthly heartworm and flea/tic preventative meds, emergency care, etc. If you cannot afford the adoption fee, can you afford the appropriate vet care? Please consider this before adopting anywhere. Are these terms acceptable to you? If so, please indicate by signing below: I certify that the information contained in this application is true and complete. I understand that by typing my name below I am electronically signing a legal agreement, and making a commitment for the life of the dog. Further, I state that I have read the Adoption Contract terms above and hereby agree that, should I adopt a dog, I will comply with all terms in a timely manner. Signed Date If you would like to send a tax deductible donation with your application, we thank you very much!!! It can be sent thru Paypal to donate@sosdogs.org.
	©2002 SOS Dogs, a 501(c)3 Non-Profit Organization. All rights reserved.