Length of time with current employer
Why are you looking to adopt a dog?
Companion
Gift
To Breed
For Children
Watch Dog
Hunting
Companion for other animal
Other
City, State, Zip Code
*
Where do you intend to keep your new dog when you are not at home?
Crate
Outside(fenced)
Outside(tied)
Basement
Garage
Free Roam of the House
One Room
Other
Are your current animals vaccinated
Yes
No
Some
Date
Dogs have been returned to us for a variety of reasons, including, but not limited to : Death, Sudden Illness, Too Energetic, Moving, Change of Job, Destruction of the home. Please list at least ONE case in which you would give up a pet. If your answer is none, please indicate what would happen to your pets in the unforeseeable instance that you could not care for them.
Cell Phone
*
Do you have a yard?
*
Yes
No
Employer/Position
What will you do if your new dog urinates in the house or chews inappropriate items?
Please list any other animals you have owned in the past 5 years (other than those listed above):
If "yes" to another shelter, what is the Name, Location and Phone Number of that shelter?
Email
*
If a portion is completely fenced in, what is the height and type?
Date
How many hours per day and days per week will the animal be alone (without human companionship)
Home
What We Do
Contact Us
Dog Applicaton
Cat Application
How you can help
How did you hear about IVAR?
We are dedicated to finding permanent, lifelong homes for our dogs. Knowing a dog can live 15+ years please consider the following. If you are a senior citizen, or will become so in the next 15 years, have you made plans in the event you are no longer able to care for your animal?
What type of identification do you intend to keep on your dog?
Employer/Position
About your new dog: How long have you been searching for a dog?
Are your current animals Spayed or Neutered
Yes
No
Some
How long have you lived at this address? If you have lived at your current address less than 5 years please include your previous address:
Thank you for your application. It can take up to one week for the application to be reviewed. Please contact dogs@illinoisvalleyanimalrescue.net if you have any questions.
What do you plan to do with your dog while you are away or on vacation?
Are all members of the household aware you are adopting a pet?
*
Yes
No
If you rent, Landord's Name and Phone number
List any animals you currently own. Please include: age, gender, size, and breed and whether they are kept inside or outside
Work Phone
If you rent, are there any size/breed limitations, if yes, describe:
If "yes" to IVAR, who and when?
What brand and type of food did or do you feed your animals?
List any and all veterinarians you have used in the past 5 years. Please include Name of Doctor/Practice, Location, and Phone number
Name of dog(s) interested in and why this dog(s) appeal to you:
Household Information: Number of adults
*
Average Hours Per Week
Were any animals ever:
Hit by car
Put to sleep
Given away
Lost
Stolen
If a veterinarian diagnosed a condition that would cost over $200 to treat, how would you handle it?
Street Address
*
Work Phone
Do you understand the link between lack of exercise and behavioral problems? How do you intend to exercise your dog?
Have you ever applied for a pet at another shelter? If yes, please include the shelter's name, location and phone number:
Average Hours Per Week
Home Phone
*
Ages of Children
Are you open to crate training?
Yes
No
Have you ever adopted an animal from IVAR or any other shelter before?
Yes
No
Driver's License #(s)
By my signature below,
Do you:
*
Rent
Own
Live with Family
Are your current animals kept on monthly heartworm and flea preventatives
Yes
No
Some
List 2 References. Please include Name, Relationship and phone number for each.
*
It may take a month or longer for your new dog to adjust to its new home. Two example issues include: a dog that is considered housebroken will have a few accidents, and a dog may begin to develop separation anxiety. Are you prepared to handle this?
If "yes" to any of the above, please describe situation:
Thank you for your application.
Birth Dates
*
Do you plan to attend obedience classes? How do you intend to reprimand your new dog?
Name (First, Middle, Last)
Are your currrent animals tested for heartworm, if yes how often?
Do you live in a:
*
House
Apartment
Condo
Mobile Home
Farm
Other
Signature - Please type in your full name
Length of time with current employer
Illinois Valley Animal Rescue Dog Application
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