NCSR Adopt a Rescue - Adoption Application

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Address:

PO Box 1147

Holly Springs, NC 27540

Phone:

(919) 434-5091

Fax:

(919) 882-9715

Email:

rescue@ncschnauzers.org

NCSR Application for Adoption
There is an Adoption Fee when Adoption is finalized that will be between $200-$300. (This helps defray the rescue's vet costs for spay/neuter, vaccinations, heartworm treatments and preventive, and many other medical costs incurred while in foster care, and is determined by the age of the dog that is being adopted.) PLEASE COMPLETE ALL QUESTIONS ON THIS FORM. If the question does not apply, answer with an "N/A" as a blank line may delay the processing of your application. NOTE: We cover and adopt out only to current residents of NORTH CAROLINA. By filling out and submitting this document, you are agreeing to allow us to contact your personal references and Veterinary reference to find out any necessary information regarding your current or previous animals.
* denotes required fields

Describe the dog you would like to adopt:
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.

Date:
Interested in NCSR dog(s):	(Enter either dog' name or number)
*Prefer:	Male Female Doesn't Matter
*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:
*Application Name:
*Street Address:
*Street Address:	,
*Driver's License:	State:
*Home Phone:
Work Phone:
Cell Phone:
*Email:
*Date of Birth:
*No. of people in the household:
*If children, please list ages:
*Are you or any member of your family allergic to pets?	Yes No
*Are you presently:	Employed Unemployed Retired Student
If employed, Employer:

Co-Applicant/Spouse Information:
*Name:
*Relationship:
*Home Phone:
Work Phone:
Cell Phone:
*Email:
*Date of Birth:
*Are you presently:	Employed Unemployed Retired Student
If employed, Employer:

Home/Environment Information:
*Type of Residence:	House Apartment/Townhouse Condo Mobile Home Farm/Barn
Do you own or rent?	Rent Own
If rental, are dogs allowed?	Yes No
Type of Street:	Very Busy Road Slight Traffic Residential Area
Speed Limit:
Where will the dog live?	Inside Only Mostly Inside Mostly Outside Outside Only
Where will the dog spend nights?	Inside Outside
Please Describe:

*Do you have a fenced yard?	Yes No
If yes, please describe (height, materials):

*How will you handle bathroom duties with the dog?

*How many hours per day will the dog be alone?
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) Quiet (Homebodies, few guests) Other
If other, please describe:

*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?
New Job New Baby Illness Other	Divorce Move None
If other, please describe:

*Have you researched Miniature Schnauzers or had experience with them in the past?	Yes No
If yes, please describe:

*Please describe the good and bad characteristics of Miniature Schnauzers as you know them:

*Are you willing to take responsibility if this pet acquires an illness in the future?	Yes No
*Are you willing and financially able to pay the veterinary costs of caring for your new pet?	Yes No
*Are you willing to take the time to work with a dog on housebreaking, chewing, or other behavioural issues if such problems arise?	Yes No
*Would you consider Obedience Training for your new dog?	Yes No
*How much time are you prepared to allow for your new pet to adjust to your home?


Current/Former Pet Information:
*Have you had pets in the last 5 years?	Yes No
*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:

*Do you consider your dog a part of the family?	Yes No
*Will your dog be on monthly heartworm prevention?	Yes No
How did you hear about North Carolina Schnauzer Rescue (NCSR)?

Have you applied with other rescue groups?	Yes No
If yes, which ones?

Would you like to become a volunteer/member of the rescue group?	Yes No

Personal References:
Please let your references know in advance we will be contacting them. No Family Members please.

Reference #1:
*Name:		Relationship:
*Phone:		Best Time To Contact:
Email:

Reference #2:
*Name:		Relationship:
*Phone:		Best Time To Contact:
Email:

Reference #3:
*Name:		Relationship:
*Phone:		Best Time To Contact:
Email:

Please Check Answer (Yes/No) beside each question acknowledging your Response:
*Will you be committed to caring for an adopted dog for its lifetime (10 to 15 years)?	Yes No
*Are you willing to keep your dog on a leash when it is not confined in the house or fenced yard?	Yes No
*I understand that it may take time to match the "right" rescue dog with my family, and I am willing to wait.	Yes No
*I realize I may need to travel within North Carolina to visit and/or pick up any dog I may wish to adopt, and am willing to do so.	Yes No
*I understand that (assuming I am approved) I will be asked to make an adoption donation of $200 - $300 when I adopt a dog from NCSR.	Yes No
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.

*Application Name:		*Date:
Co-Application Name:		Date:

North Carolina Schnauzer Rescue, Inc. is a 501(c) (3) tax exempt non-profit organization. Website design and content are © 2008 North Carolina Schnauzer Rescue, Inc. unless otherwise noted. Please do not copy or take anything from this website without written permission.