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Texas Flyers Dog Rescue

Adoption Application

Number fields are numbers ONLY; Phone fields are entered as xxx-xxx-xxxx *

I Understand

When you submit your application, you will receive a copy of your application with all the questions and your answers in your email. *

I Understand

Check your email and bulk folder and if there is not a copy , then unfortunately, we did not receive it. *

I Understand

Dog Name – 1st Choice *

What dog are in interested in?

Dog Name – 2nd Choice

What other dog would you be interested in?

If the dog you are applying for is not a good fit for your family, would you consider a dog we recommend?

Strongly Consider
Consider
Neutral
Would Not Consider
Other

Please explain or other comments

Applicant Information – Name *

First

Last

Applicant Information

Mobile Phone

Numbers 222 222-2222

Home Phone *

Numbers 222 222-2222

Work Phone

Numbers 222 222-2222

Email *

Age – Numbers Only *

Street Address – Street Number and Name *

We cannot process your application without a complete street address with your house number and street name

City *

State *

Zip Code *

ONLY numbers – sample: 12345

Applicant Employer *

Applicant Occupation *

Applicant Work Schedule *

Co-Applicant Information – Name

First

Last

Mobile Phone

Numbers 222 222-2222

Home Phone

Numbers 222 222-2222

Work Phone

Numbers 222 222-2222

Email

Age – Numbers Only

Street Address – Street Number and Name

We cannot process your application without a complete street address with your house number and street name

City

State

Zip Code

ONLY numbers – sample: 12345

Co-Applicant Employer

Co-Applicant Occupation

Co-Applicant Work Schedule

How did you hear about us? *

What is your time frame for adoption? *

Where else have you applied?

Please list organization name

Why do you want a rescue dog?

Dog Sex *

Male
Female
Either

If sex is required, explain.

Dog Age – Check all that apply

Baby (0-6 months)
Baby (6 months-1 year)
Young (1-2 years)
Young (2-3 years)
Adult (3-6 years)
Senior (7+ years)

Dog Size – Check all that apply

Small (0 – 40 lbs.)
Medium (41 – 65 lbs.)
Large (66 – 90 lbs.)
X-Large (91+ lbs.)

EnergyLevel/activity level desired – Check all that apply

High
Moderate
Low
Total couch potato

Would you be interested in adopting a bonded pair?

Yes
No

List in order the characteristics you want in a dog:

Not Acceptable – Check all that apply

Alpha/Dominant
Needs Obedience training
Requires Fencing
Medication Dependent
Excessive Barking
Mouthing
Separation Anxiety Issues
Timid/Scared
Physically Handicapped, 3 legs or 1 eye

Check the behaviors or characteristics that are not acceptable (please bear in mind the majority of RESCUE dogsneed obedience training to some degree, need work on basic leash skills, house manners, and may not be housetrained)

Other

List any other unacceptable behaviors.

Have you ever owned any kind of dog before? *

Yes
No

Have you ever owned a rescue dog before? *

Yes
No

Where did you rescue your previous dog?

Please list name, city & state of organization

Do you have any other animals?

Bird, horse, etc.

Breed

For each animal you own, please list:

Sex

For each animal you own, please list:

Age Lived

For each animal you own, please list:

Have you ever…

Had a pet become lost?
Had a pet poisoned?
Sold a pet?
Had a pet killed by a vehicle?
Had a pet treated for a disease?
Surrendered a pet to a shelter?

Check all that apply

IF YES, TO ANY OF THE ABOVE, EXPLAIN IN DETAIL

YOUR APPLICATION MAY NOT BE CONSIDERED FURTHER WITHOUT ADEQUATE DETAIL

Pets Names

For each animal that you own, please list.

Breed

For each animal that you own, please list.

Age

For each animal that you own, please list.

Gender

For each animal that you own, please list.

Spayed or Neutered

For each animal that you own, please list.

What food(s) does your current dog eat?

For each animal that you own, please list.

How often?

For each animal that you own, please list.

Are all pets up-to-date on vaccinations (this is a requirement for adoption)?

Yes
No

If "no," please explain why not.

List preventative treatments current pets receive and frequency of dosage:

Have you and your dog gone to training? Describe your experience and if you accomplished your objective.

Have you had any other training previously with other pets? Describe your experience and if you accomplished your objective.

Where would you enroll your next dog for obedience training if it is needed?

Describe your experience introducing an adult dog into your home to your current pets.

How will your dog be exercised and how often do you plan to provide this exercise?

How often and under what circumstances will your dog be left unattended outside?

How often and under what circumstances will your dog be allowed to be off-leash?

Do you have a tie out or runner for your dog?

Yes
No

If yes, you MUST explain how and when it is used:

How many hours a day on average will the dog be home alone without adults?

Will the dog be primarily kept:

Indoors
Outdoors

Where will the dog be kept when no one is at home?

What provisions will be made for your rescued dog during those times?

Where will your rescued dog sleep?

Will your dog:

Be crated
Be kept in a dog house
Have the run of the house
Be tied or attached to runner outside
Be in a blocked-off portion of the house

Do you live in a: *

House
Townhouse
Duplex
Condo
Apartment
Other

Do you have a yard?

Yes
No

What is the size of your yard–area for dog?

Is it completely fenced?

Yes
No

What is the height and type of fence?

Dog safety and exercise plan

If no fence or partial fencing how will your dog will be allowed to exercise, play, and relieve him/herself while being kept from running away, getting lost, or getting hurt?

Do you rent or own? Required, must choose one. *

Rent
Own

Do you have permission to keep a large dog?

Yes
No

Landlord's Name

Name of Landlord or Housing Manager

Company Name

Name of Apartment or Company

Phone

ONLY numbers sample: xxx xxx-xxxx

Landlord Email

Apt, Suite, Bldg

Street Address

City

State

Zip Code

How many children in the house?

Ages of children in the house

Describe their (children’s) experience/exposure to large dogs:

How often do you have young children visit (grandchildren or friends of children)

If you have children, what precautions will you take to ensure children and the dog(s) can co-exist safely?

How many adults live in the household? – Number Only

Other then applicants

Ages household members in the household

Other then applicants

Relationship other household members to applicant(s)

Does everyone in your household want to get a rescued dog?

Yes
No

Who will be responsible for the care of the dog?

Who will be responsible for the training?

How will the children and household members be involved with care of dog?

Is anyone in your household allergic to animals? Please specify cats, dogs, long hair etc

Yes
No

If yes to allergic and/or gift, please explain:

How often do you travel and who will care for your dog when you are away?

Please note if person is related or daycare

Are you willing to travel more than 2 hours to pick up your dog?

Yes
No

Will this dog be a gift?

Yes
No

If the dog is a gift, then for whom?

Does the recipient know?

Yes
No

Are you planning to move in the near future?

Yes
No

If yes, please explain:

Whenever you DO move, what will you do with your dog?

Current Vet Name *

IF YOU DO NOT HAVE A VET, PLEASE ENTER THE VET’S INFORMATION BELOW WHERE YOU WILL TAKE YOUR DOG TO FOR VACCINATIONS * PLEASE CALL THEM AND LET THEM KNOW THAT YOU WANT ADOPT A DOG AND SET UP AN ACCOUNT FOR THEIR SERVICES

Organization

Current or new vet? *

Current
New

Phone – Numbers Only Format XXX XXX XXXX *

Street Address

Apt, Suite, Bldg

City

State

Zip Code

Past Vet Name

Organization

Phone

Numbers 222 222-2222

Street Address

Apt, Suite, Bldg

City

State

Zip Code

Most Important Question Please use this space to tell us anything about you which you think may be helpful. Please remember, only the best applications are selected for our dogs – here is your chance to tell us why yours is one!

Why is this question essential? The application you just completed is very important however, the questions tell us all about your life. The question below is important because it helps us get to know you and in many cases helps us with our decision. You could be a wonderful applicant but we won’t know unless you tell us here.

If you had dogs before, what was that experience like that moved you to continue to want a dog in your life? Why did you spend hours on end looking for a dog? What will this dog do for you and most important, what will you do for this dog. In the end, who really rescues who?

Is there someone who will take care of your pet if you cannot for medical reasons?

Yes
No

If so, please fill out the questions below.

First Name

Last Name

Home Phone

Numbers 222 222-2222

Cell Phone

Numbers 222 222-2222

Email

Street Address

Apt, Suite, Bldg.

City

State

Zip

What is the relationship of the new owner to you?

Friend
Family

Are other family members or your attorney aware that:

Made arrangements for your pet
Plan on making arrangements

Has your current or previous pets met them?

Yes
No

Do they have other pets?

Yes
No

What current or previous pets have been with then new owner: Cat, dog, horse etc

Call Your Vet. You will call your vet and give them permission to speak with us right after your application is submitted. *

I agree

Home Visit. Allow a rescue volunteer to complete a home visit in order to approve adoption and at least one follow up visit after adoption? *

I agree

Medical Agreement. Your rescued dog must ALWAYS be kept on monthly heartworm prevention for the first 12 months consecutively you have him/her, and as recommended by your vet thereafter. *

I agree

Removal. We reserve the right to remove a dog at any time should we find the adopter is no longer caring for their rescued dog n in a way we see fit. We also require adopters to agree to follow up visits as needed. We are committed to our dogs before, during and after adoption! *

I agree

Authorization. By submitting this form I hereby authorize a Texas Flyers Dog Rescue. representative to verify all information provided on this form and give your veterinarian permission to disclose all medical information requested. *

I agree

Accuracy of information provided. All of the information I have given in this questionnaire is true and complete. Should a rescue animal be placed with me, it will reside in my home as a pet. I agree to provide all necessary veterinary care, food, shelter, love (including hugs and kisses) and an ample supply of tennis balls, affection and care! *

I agree

Signature. By entering my signature here, means I have agreed to all the terms in this form and agree that Texas Flyers Dog Rescue. are released and indemnified from any and all claims, known or unknown, now or hereafter arising in connection with any dog placed in your home. *

I agree

Submission of an application DOES NOT guarantee a dog will be placed with you. *

I agree

THE FEE INCLUDES ALL VACCINATIONS, ANY NECESSARY MEDICAL TREATMENTS, KENNELING AND TRANSPORTATION COSTS AND ARE SUBJECT TO CHANGE AT THE DISCRETION OF RESCUE DOG VILLAGE. If you have any questions, please ask. *

I agree

Signature *

Enter your full, legal name.

Phone

Numbers 222 222-2222

Phone