California Miniature
Schnauzer Rescue
—Adoption Application—So. Cal.
Please copy the Adoption Application form below into an e-mail addressed to cmsr@schnauzers.us, complete the requested information, and then send the e-mail.
To copy the form into an email, do the following:
1. select the text (CTRL-A on a PC; Command-A on a Mac),
2.
copy the text (CTRL-C on a PC; Command-C on a Mac), and
3. paste the text into an email window [put cursor into the text window of a new e-mail message form, then paste the text (CTRL-V on a PC; Command-V on a Mac)].
You can then type into the blanks just as when typing any email.
Adoption Application
Today's Date:
You and Your Family
Your Name:
Your Occupation:
Spouse's Name:
Spouse's Occupation:
Home Street Address:
City, State & Zip Code:
E-Mail Address:
Work Phone:
Home Phone:
Cell Phone:
Do you have children living at home? Yes __ No __
If so, number and ages:
Please identify any other people living in the home and their relationship to you:
Pet(s) You Wish To Adopt
Name(s):
Put me on the waiting list for available rescue dogs: Yes __ No __
Preferences (sex, age, activity level):
Who is the pet for?
Are you looking for an inside pet or an outside pet?
Your Home
Do you live in a single family residence? ___ apartment? ___ town house? ___ mobile home? ___
Is your yard fenced? Yes __ No __
What type of fencing?
How high is the fencing?
Are the gates secure and locked? Yes __ No __
Do you have a pool? Yes __ No __
Is the pool securely fenced off from yard? Yes __ No __
Ownership of Home
Do you own the home in which you are living? Yes __ No __
If not, do you have the owner's permission to have a pet? Yes __ No __
May we contact owner to verify? Yes __ No __
Owner's name?
Owner's phone number?
Does the owner impose any weight restrictions on pets? Yes __ No __
What?
Living With a Pet
Where will the pet stay during the day?
Where will the pet stay at night?
How many hours and where will the pet be exercised?
How many hours and where will the pet be left at home alone?
Other Pets
Do you have other pets? Yes __ No __
Please describe your other pets.
Are your current pets neutered? Yes __ No __
Prior Pets
Have you ever surrendered a pet in the past? Yes __ No __
Why?
What happened to your prior pets?
Professional Help
Do you currently have a veterinarian? Yes __ No __
If so, please furnish name and phone number:
Are you willing to take the dog to training classes? Yes __ No __
Would you be willing to call in a trainer if a problem developed that you were unable to handle on your own? Yes __ No __
Who will take care of the dog when you travel?
Future Care
Dogs may live 15 years or more. What plans have you made for care of your pet if you become no longer able to care for the pet?
What would cause you to give up your pet and what would you then do with him/her?
Other information you deem pertinent to your application:
By submitting this application, I represent that the above information I have provided is accurate, and I agree to allow rescuers to verify this information.
I understand that you reserve the right to refuse adoption to any applicant.
This application will become part of the adoption contract.
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