First Name:
Last Name:
Age:
E-Mail:
Occupation:

Partner First Name:
Partner Last Name:
Age:
E-Mail:
Occupation:


Street Address:
City:
State:
Zip:

Home Phone:  Best Time to call:
Cell Phone :  Best Time to call:

Are all adult family members in agreement to adopt a rescue dog? Select Yes No

If there is a specific dog that you are interested in adopting, please fill in the name, it will make the processing of your application faster.  

Name of specific dog and/or breed are you interested in adopting?
Are you willing to adopt an older dog? Select Yes No

How many hours a day will the dog be home alone?
Where will he/she be kept during that time?


Is your yard securely fenced in? Select Yes No
If No, how do you intend on safely exercising and relieving your dog?
If Yes, please provide a description of fence (chain link, wood privacy, etc)

Are there any children in your home? Select Yes No
Please list their names and ages:
Name:  Age:
Name:  Age:
Name:  Age:
Name:  Age:
Name:  Age:

Do you Rent or Own? Select Own Rent
If  you rent, please provide your Landlord information below.
Landlord:
Address:
City:
State:
Zip:
Phone:   Best time to call:
NOTE: Verification of pet rules for renters is a condition of adoption, so you must supply this information.

NOTE: If you or your vet refuse to release your vet information to CRA your application will be rejected!

Please list your current vet's name, address, and phone number:
Vet/Vet Hospital:
Address:
City:
State:
Zip:
Vet Phone:
Hours of operation:

Please list your past vet's name, address, and phone number:
Vet/Vet Hospital:
Address:
City:
State:
Zip:
Vet Phone:
Hours of operation:

Please list your current and past pets that have lived in your home during the past 5 years.

If you have or have had other animals within the past 5 years please list and provide information. 

Have you ever given an animal away? Select Yes No
If Yes, please explain the circumstances that lead to your decision and how you placed the animal.

Have you ever adopted a rescue animal before? Select Yes No
If so, please advise what rescue you adopted from and the current status of the rescued animal  

Do you understand that rescue animals have, in all likelihood been abused, neglected, mistreated, and/or abandoned? Select Yes No

We do not guarantee that our dogs are potty trained.  95% of the time, or more, our rescues are not able to be successfully housetrained.  Are you willing to accept accidents for the life of this dog?  Select Yes No

If you understand this, are you still committed to providing a forever home for this fur family member?  Select Yes No

Please explain your views on crate training dogs.

Are you agreeable to a home visit?  Select Yes No
Note:  Home visits are a requirement of adoption from Chris’ Rescue Angels.  If you answer NO, your application will not be processed.  

We know that at times circumstances arise in a family that effect their ability to keep their dogs.  Do you understand that, if for any reason, you are not able to keep the dog – you are contractually required to return him/her to Chris’ Rescue Angels?  Select Yes No

Our dogs are fostered throughout the United States .  We do allow adoptions throughout the country.  However, if the dog and adopter are not located near each other, it is the responsibility of the adopter to arrange and pay for transportation of their new fur family member’s transportation home.  Are you agreeable to that?  Select Yes No

How did you find us?
 

By submitting this application via e-mail, I hereby certify that all of the information provided is accurate, to the best of my knowledge.  I understand that by typing in my name below, along with the date, Chris’ Rescue Angels accepts that, and I agree to its use, as an acceptable substitution for my written signature.

Full Name of Applicant:   Date :

Chris’ Rescue Angels reserves the right to refuse adoption to any applicant, at any time, without reason or explanation.  We believe it is our obligation to protect the long term welfare of the animal entrusted to our care.  While we strive to process and complete applicants in a timely manner; our adoption process is in place for the protection of our dogs – not the convenience of our adopters. 

In addition, while we can provide you with the vetting history and other pertinent information since the dog came into rescue, we can not make any claims or guarantees regarding its past history and/or any possible future problems.  You agree that by submitting this application, you release Chris’ Rescue Angels from any liability regarding possible future behavioral problems, including – but not limited to, aggression towards other animals, aggression towards humans (including biting), and property damage.