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Lucky Pup Rescue Adoption Form 2013

Begin by filling out the Lucky Pup Adoption Form

Lucky Pup Rescue Adoption Form 2013

Estimated time to complete: 25-30 minutes

Dear Potential Adoptive Family,

Please note that processing your application takes some time for the volunteers at the rescue. If you are not willing to wait and to assist in the process (generally 1-2 weeks) please do not fill out the application. Our time could be spent saving other dogs rather than taking the time to work on yours, only to find that you got a dog elsewhere or didn’t want to wait.

When you find your new family member, it will be well worth the couple of weeks it took to find a great match! Your honest, thoughtful answers will help us find a family member that suits you AND the dog.

We at Lucky Pup Rescue, Inc. are committed to finding the best “doggie” fit for you and your lifestyle so you all will have many happy years together.

Our adoption process includes (in this order) the completion of an application, veterinary and personal reference checks, home visit, and the meeting of potential dogs. This is followed by the exchange of the adoption fee and contract if you choose to adopt. You will then receive all veterinary paperwork that we have on the dog by mail or email.

The standard adoption fee is $300.00 for dogs through age 6, or $250.00 for dogs age 7 and older. This helps to cover adoption costs, transportation to New England if applicable, vaccinations & medical costs, so that we may continue to rescue other at-risk dogs. (Costs may vary in unusual circumstances.) In the rare case that a dog is unaltered, an additional spay/neuter contract and $100.00 refundable deposit will be collected, per state of Maine law.

All fees need to be paid via Pay Pal or by check or cash (mailing address: Lucky Pup Rescue, PO Box 461, Kennebunkport, ME 04046) after your application is approved. We will not release any dog’s veterinary paperwork until payment has been received.

Please answer ALL questions, or write N/A if a question is not applicable to you. If you have questions about filling this form out, please contatct us at luckypuprescue@yahoo.com.

Please take the time to read through all sections. There are two very important sections at the end regarding our expectations and commitment to you, and yours to us and your new dog.

You do not need to sign the application until adoption; at that time we will get your written signature.

This application serves as your adoption contract if you are approved and find a suitable dog through Lucky Pup Rescue, Inc. You must be 23 or older and living in New England to complete & submit the application.

 We reserve the right to refuse any applicant for any reason if we feel the needs of the dog will not be properly met, or that the adoption is not in the best interest of the dog.

 Thank you for your interest in rescuing a dog through Lucky Pup Rescue!

Sincerely,
The Lucky Pup Rescue Adoption Team


We are experiencing an issue with Internet Explorer as well as Tablets. Please submit this form on a home computer using Firefox, Chrome, or Safari, or download a PDF copy of our application.

You must be 23 years old or older and living in New England in order to be considered for adoption with Lucky Pup Rescue. Please do not fill out this form if you are under the age of 23 or are not living in New England.

Our adoption process begins by completing the following online application. Once you've answered all of our questions, you'll be given an Adobe PDF file that you will need to print, sign, and bring with you when you go to meet a dog that you are interested in adopting.

Once we have received your online application, our team of volunteers will start work matching you with your perfect companion!

Ready? Let's get started!

Contact Information



First Name (*)

Please tell us your first name
Last Name (*)

Please tell us your last name
Co-Applicant Name

Please enter the name of your co-applicant if applicable.
Home Phone

Please enter your phone number in the following format: 207-850-1234
Cell Phone:

Please enter your phone number in the following format: 207-850-1234
Email Address (*)

Please enter a valid email address
Physical Address (*)

Please enter your physical address.
City (*)

Please enter the town or city that you live in
State (*)

Please enter the state that you live in
Zip Code (*)

Please enter your zip code
Work Location

Please enter your work location
Work Phone

Please enter your work phone number
When is the best time of day to contact you?

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Household Information




Please list the names and ages of all humans living in your household, including yourself:

Name: (*)

Please enter the person's name.
Age: (*)

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Name:

Please enter the person's name.
Age:

Please enter the person's age.
Do all members of your household want to adopt a dog? (*)

Please let us know if everyone in your household is on-board with getting a new dog
If not, please explain:

Please indicate who in your family does not want to adopt a dog and why.


Household Information (Continued)




Please list the details for all dogs living in your household including their ages, gender, breed(s), whether they are altered, and if they have any special needs.

Dog 1 Name:

Please enter the name of your pet.
Age:

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Gender:

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Breed:

Please enter the name of your pet.
Is this dog spayed or neutered?

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Does your pet have any special needs? If so, please explain.

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Name:

Please enter the name of your pet.
Age:

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Gender:

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Breed:

Please enter the name of your pet.
Is your pet spayed or neutered?

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Does your pet have any special needs? If so, please explain.

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Name:

Please enter the name of your pet.
Age:

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Gender:

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Breed:

Please enter the name of your pet.
Is your pet spayed or neutered?

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Does your pet have any special needs? If so, please explain.

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Name:

Please enter the name of your pet.
Age:

Please enter the age of your fourth pet
Gender:

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Breed:

Please enter the name of your pet.
Is this dog spayed or neutered?

Please indicate whether your pet is fixed
Does your pet have any special needs? If so, please explain.

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If any of your dogs are not up-to-date on vaccinations, please explain:

Please answer the question.
Please list all other animals in your household, including their species, genders, and ages:


Do any of your other pets have special issues?

Please indicate whether any of your current pets have special issues.
If any of your pets have issues or special circumstances, please explain:

Please explain any of your pets' existing issues:
If you do not have small children living in your home, will your rescue dog come into regular contact with any children under the age of 10? If so, please explain. (*)

Please list the details of children under 10 that your adoptive dog will spend time with, or enter ,"No," in the box if this does not apply to your situation.
Does anyone in your household have allergies? (*)

Please indicate if anyone in your household has allergies
If yes, what kind of allergies?

Please indicate what kind of allergies your household members have.


Background Information



How long have you lived at your current residence? (*)

Please indicate how long you've lived at your current residence.
Do you own or rent? (*)



Please let us know if you rent or own
If you rent, has your landlord provided written permission for you to have a dog? (*)

Please answer the question regarding whether or not you have permission to have a dog, or select the, "Not applicable," choice if you do not rent.
If you rent, are there any restrictions on breed, size, etc.?

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If you rent, please provide your landlord's name and phone number.

Landlord's Name:

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Landlord's Phone Number:

Please enter a phone number in the following phone number: 207-850-1234
How far are you willing to travel to pickup your rescue dog? (*)

Please indicate how far you are willing to travel to pick up your rescue dog.
If you do not have a dog now, have you had dogs in the past?

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Have you ever surrendered an animal to a shelter or rescue organization? (*)

Please answer the question
Please explain:

Please explain why you had to relinquish a previous pet
Have you ever sold, given away, or put down a pet? (*)

Please indicate whether you've ever sold, given away, or put down a pet.
If so, please explain:

Please explain why you sold, gave away, or put down a pet.


Information on the Care of your Dog



Do you have a specific dog that you are applying to adopt? (*)

Please indicate whether you've already chosen your favorite adoptable dog.
If there is a specific dog that you wish to adopt, please enter the dog's name here:

Please enter the name of the dog you wish to adopt.
If you have a particular dog in mind, are you willing to consider other dogs if that dog is unavailable to you or is not a good match for your situation?

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If you don’t have a specific dog in mind (or even if you do, you may elaborate on this question), please tell us what you are looking for in terms of age, gender, breed, energy level, color, size, etc.

Please enter the details about the type of dog you wish to adopt.
How many hours per day will your dog(s) be home alone (without humans) on a regular basis? (*)

Please specify the number of hours your dog will be alone per day
Do you have a fenced-in yard? (*)

Please tell us if you have a fenced-in yard

If you do have a fenced-in yard, please describe it in the fields below:

What type of fence is it (i.e., wood, chain link, invisible, etc.)?

Please indicate which type of fence you have.
What are the dimensions of your fence (i.e., 4’x10’, 1/4 acre, etc.)?

Please enter the width of your fence
How high is the fence?

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If you do not have a fence, are you willing or planning to install one? (*)

Please answer the question regarding whether you have any plans to install a fence.
Will the dog(s) be kept on a runner or tied outside? (*)

Please answer the question
Will the dog(s) live in the yard? (*)

Please answer the question
Will the dog(s) be walked daily? (*)

Please answer the question
Will the dog(s) be exercised in a fenced yard? (*)

Please answer the question
Will the dog(s) be allowed to run free outside of a fenced yard? (*)

Please answer the question
Who will be primarily responsible for your rescue dog's care, training, and exercise? (*)

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How will you exercise your rescue dog? (*)

Please indicate how you will exercise your rescue dog.
Where will your rescue dog(s) be kept during the day? (*)

Please answer the question.
Where will your rescue dog(s) be kept at night? (*)

Please enter a response.
Where will your rescue dog(s) be kept when you are not home? (*)

Please enter a response.
Will the dog(s) be allowed in the house? (*)

Please answer the question
Will the dog(s) be kept out of certain areas in the house? (*)

Please answer the question
Are you familiar with crate training (adult dogs should never be left for more than 6 hours in a confined crate, and puppies should never be left longer than 3 hours)? (*)

Please answer the question.
Are you willing to use a crate for your rescue dog? (*)

Please answer the question.
What will you do with your dog(s) if you need to be away from home overnight? (*)

Please answer the question.
Are you aware that costs of maintaining a dog can average $500-$1000 or more a year (food, annual check ups & shots, heartworm & flea/tick prevention, grooming, etc.)? (*)

Please answer the question.


Reference Information



Do you have a veterinarian for present or former pets? (*)

Please answer the question
Vet's Name:

Please enter your vet's name
Vet's Phone Number:

Please enter your vet's phone number in the following format: 207-850-1234
Vet Address:

Please enter the address for your current vet.
City

Please enter the city that your vet is located in.
State

Please enter the state for your vet.
Zip Code

Please enter the zip code for your vet.

Please provide us with two personal references that are not relatives or household members.

Name (*)

Please enter the name of your first reference
Phone Number (*)

Please enter the phone number for your first reference
Relationship (*)

Please enter the details of the relationship you have with your first reference.
Name (*)

Please enter the name of your second reference.
Phone Number (*)

Please enter the phone number for your second reference.
Relationship (*)

Please enter the details of the relationship you have with your second reference.
May we visit your home prior to application approval? (*)

Please indicate whether or not you are okay with a home visit
May we visit your home after the adoption for a follow-up visit? (*)

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Information and Questions Regarding the Care and Training of your Dog


It is strongly recommended that to build a bond with your new dog and establish the ground rules in your family that you enroll in a positive reward-based training class after your dog has settled into your home.

Will your dog(s) receive formal obedience training? (*)

Please answer the question.
If yes, please identify the obedience trainer (we are happy to provide references if you like, just ask!):

Please enter the name of your obedience trainer.
Have you or any member of your family/household been cited for leash law violations or animal cruelty? (*)

Please answer the question.
If yes, please explain:

Please enter details of the incident(s).
Once you adopt, are you amenable to the rescue sharing your email address with the foster family or adopters of your dog’s siblings, etc? (*)

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On a scale of 1-10 (1 being the lowest level and 10 being very dedicated) what is your level of commitment to working with any behavior issues that a rescue dog may have? (*)

Please indicate your level of commitment.
Please elaborate if you'd like:

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If you move, what will you do with your dog(s) (and/or other pets)? (*)

Please answer the question.
Do you understand the state/local ordinances concerning dog licensing and leash laws? (*)

Please answer the question.
What would you do if one of your pets requires significant medical attention? (*)

Please answer the question.
Why do you think you would be a good adopter for rescue dog(s)? (*)

Please answer the question.
Are you working with other rescues or shelters towards adoption at this time? (*)

Please enter a response.
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