Date:
Interested in NCSR dog(s) - Name(s)/Number(s):
NOTE: There is the possibility that the dog(s) you apply for could be adopted by someone else before you complete the application approval process. Please only apply if you are willing to entertain other dogs for adoption as they come into the rescue, and are not just set on adopting 1 particular dog. You may still be able to adopt the dog you apply for, but understand that statuses of the dogs can change on a daily basis, and we receive MANY applications for each dog.
* Prefer:
* Age range of dog desired:
* Oldest dog considered:
* Describe any other preferences for the dog you adopt (temperament, physical traits, special needs, etc.):
* Is your family willing to work with a new dog on any issues that he/she may have?
* What dog behaviors or characteristics would be unacceptable to your family?
Applicant Information
* Applicant Name:
* Street Address:
* City:
* State:
* Zip:
Drivers license:
State:
* Telephone home:
Work:
Cell:
* Email Address:
* Date of Birth:
* No. of people in the household:
1
2
3
4
5
6
7
If children, please list ages:
Are you or any member of your family allergic to pets?
* Are you presently:
Employed
Employer:
Unemployed
Retired
Student
Co-Applicant/Spouse Information
Co-Applicant/Spouse Name:
Relationship:
Telephone home:
Work:
Cell:
Email Address:
Date of Birth:
Are you presently:
Employed
Employer:
Unemployed
Retired
Student
Home/Environment Information
* Type of residence:
House
Apartment/townhouse
Condo
Mobile Home
Farm/Barn
Do you rent or own?
Rent
Own
If rental, are dogs allowed?
Yes
No
Type of Street:
Very Busy Road
Slight Traffic
Residental Area
Speed Limit:
Where will dog live?
Inside Only
Outside Only
Mostly Inside
Mostly Outside
Where will the dog spend nights?
Inside
Outside
Describe:
* Do you have a fenced yard?
Yes
No
If Yes, describe it (height, material) :
* How will you handle bathroom duties with the dog?
* How many hours per day will the dog be alone?
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Where will the dog stay when left alone?
Describe the activity level in your home:
Busy (visits by friends, meetings, children, parties at home)
Noisy (TV, stereo, machinery, tools, children playing, dogs barking)
Moderate (Normal comings and goings)
Quiet (homebodies, few guests)
Other
(specify)
* In the absence of the primary caregiver (due to illness, death, or other inability to care for a pet, etc), who will care for the dog?
* Under what circumstances would you need to return the dog to us?
* Have you researched Miniature Schnauzers or had experience with them in the past?
* Please describe the good and bad characteristics of Miniature Schnauzers as you know them:
* How much time are you prepared to allow for your new pet to adjust to your home?
Current/Former Pet Information
* Please list any current or former pets within the past 5 years (names, breeds, ages) and where they are now:
* Current or past VETERINARIAN information (Must include Vet's Name , Address, and Phone # - if no vet in the last 5 years, please put "n/a" since this is a REQUIRED field ):
Are all your pets (current or past) spayed or neutered:
Yes
No
Are your pets (current or past) up to date on all vaccinations?:
Yes
No
Are your pets (current or past) on heartworm preventive:
Yes
No
If you answered no to any of the above questions, please explain your answer:
Personal References
(Please let your references know in advance we will be contacting them. No Family Members please.)
Please Check Answer (Yes/No) beside each question acknowledging your Response:
Knowing that there are more applicants than there are available dogs, is there anything else that you want to tell us that might help us understand what makes your home the best environment for one of these rescues to spend the remainder of his or her life?
Thank you for taking the time to complete this application form. Your application will be reviewed, references will be contacted, and then a home visit will be scheduled prior to final approval for adoption.
This approval process usually takes 2-4 weeks, depending on how quickly your references are contacted and how close we have members available to complete your home visit. If you have any questions regarding your application status at any time, please contact us. We reserve the right to deny any application without explanation to the applicant, and if not approved, you will be sent a denial letter via postal mail from our application review board. If you are APPROVED for adoption, you may also be added to our email list: NCSR-supporters@yahoogroups.com so you may stay apprised of all our rescue happenings, incoming dogs, etc.
Submitting an application does not guarantee you will receive a rescued dog. Should your application not be approved, it is not a reflection on your ability to provide a good home for another dog. We do not have a sufficient number of rescue dogs to place one with each applicant that applies and must be very selective in their placement to assure they are in their adoptive homes for the remainder of their lifetimes.
I agree to notify NCSR ( rescue@ncschnauzers.org ) should I wish to cancel this application. If you adopt elsewhere before you adopt from us, please let us know as soon as possible so that our volunteers can focus only on active applicants.
Applicant Name:
Date:
Co-Applicant Name:
Date: