EDPR Adoption Application

Thank you for your interest in adopting one of our dogs, so that we find the right pet for you and your family, please answer all of the questions as completely as possible. The form WILL NOT submit if any required questions are left blank.

Your Information
Your Name Your Name * First Last
Pet(s) looking to Adopt *
Today's Date Today's Date * / MM / DD YYYY
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Birthday *
Cell Phone *
Other Phone
Drivers License # *
Best way to reach you? *
Household
Please list names, ages and relationship of all adults/children in the household. (one per line please)
Name -------------- Age --------------- Relationship *
Does anyone in then household have allergies? *
If there are no children living with you are there children that visit? For example, grandchildren, children you babysit ect...? *
How often do you travel? *
Are you planning a vacation in the near future? *
Dwelling Information
What type of house do you live in? *

What type of house do you live in? House Apt/Condo Townhouse Duplex Single Family Farm
Do you own or rent? *

Do you own or rent? Own Rent
If you rent, does your landlord allow pets? *
If you rent, please list your landlords Name & Phone # so we can verify *
How long have you lived at this address? *
Do you plan on moving any time soon? *
Do you have a fenced yard? If so, please briefly describe it: *
If not, how will you exercise the dog? *
Pet Information
Have you ever fostered an animal? If so, what was your experience? *
Have you ever owned a dog before? If so, what types of breeds? *
Have you ever crate trained a dog? *

Have you ever crate trained a dog? Yes No
What kind of experience have you / do you have with dogs? (dog training, vet tech, groomer, agility, happy pet owner, ect...) *
What pets do you currently own? How long have you had them? *
Are your current pets spayed/neutered? *

Are your current pets spayed/neutered? Yes No N/A
Are your pets current on their vaccinations? *

Are your pets current on their vaccinations? Yes No N/A
Can you provide proof of spay/neuter and vaccinations dates/locations? *

Can you provide proof of spay/neuter and vaccinations dates/locations? Yes No N/A
How many hours a day will your pet be left alone? *
Where will the pet stay during the day? During the night? *
Who will be the primary caretaker? *
What kind of dog are you interested in? (Name of dog, breed, gender, size, etc.)
Are you willing to have someone from this rescue organization visit your home? *

Are you willing to have someone from this rescue organization visit your home? Yes No
Personal Reference 1
Name Name * First Last
Occupation & Relationship *
Phone Phone * - ### - ### ####
Personal Reference 2
Name Name * First Last
Occupation & Relationship *
Phone Phone * - ### - ### ####
Adoption Agreement & Signiture
I understand and agree to all the information provided to me in my application process. If the animal I adopt is on medication, I will continue the medication as directed. I will not let the animal out loose by itself. If during the time I have this animal I have to rehome it for any reason, I will contact East Dallas Pet Rescue (EDPR) first. I understand the animal is property of East Dallas Pet Rescue (EDPR) and I will not sell, trade or dispose of the animal. I understand the importance of my animal being up-to-date with on all standard vaccinations, being spayed or neutered, and must provide East Dallas Pet Rescue with copies for each of these. Adoption fees are Non Refundable.
*

I understand and agree to all the information provided to me in my application process. If the animal I adopt is on medication, I will continue the medication as directed. I will not let the animal out loose by itself. If during the time I have this animal I have to rehome it for any reason, I will contact East Dallas Pet Rescue (EDPR) first. I understand the animal is property of East Dallas Pet Rescue (EDPR) and I will not sell, trade or dispose of the animal. I understand the importance of my animal being up-to-date with on all standard vaccinations, being spayed or neutered, and must provide East Dallas Pet Rescue with copies for each of these. Adoption fees are Non Refundable.
Yes No
ALL OF THE INFORMATION I HAVE SUPPLIED ON THIS APPLICATION TO MY KNOWLEDGE IS TRUE AND COMPLETE. I UNDERSTAND THAT FALSIFYING ANSWERS ON THE APPLICATION OR AT ANY OTHER TIME DURING THE ADOPTION PROCESS, DISQUALIFIES ME FROM ADOPTING.

I understand that although East Dallas Pet Rescue (EDPR) takes reasonable care to screen the animals for adoption placement, it makes no guarantee relating to the animals health, behavior or actions. I understand that I receive my adopted animal at my own risk and can reject or return any animal for which the rescue has asked me to provide care to. I indemnify and hold the rescue free and harmless from all liability arising out of control and all claims, demands, losses, damages, action or judgement of any kind and description which may occur or be suffered by me, members of my household, my own animals, or any third party by reason of activities arising out of this agreement. I release the East Dallas Pet Rescue (EDPR) from any responsibility for diseases, Actions or behavior.
Please sign *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date * / MM / DD YYYY
For Office Use Only (leave blank)
East Dallas Pet Rescue Representative: _______________________________________________________________
Date: _________________________________________________________
Dog release number: ______________________________________________

Cat release number: ______________________________________________

Age: ________________________ Sex: _______________________

Name:_________________________________________________________

Color: _________________________________________________________

Special Needs:
Thanks and have a blessed day!
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EDPR Adoption Application

EDPR Adoption Application

Your Information

Household

Dwelling Information

Pet Information

Personal Reference 1

Personal Reference 2

Adoption Agreement & Signiture

For Office Use Only (leave blank)

East Dallas Pet Rescue Representative: _______________________________________________________________

Date: _________________________________________________________

Dog release number: ____________

Cat release number:

Age: Sex: _

Name:_

Color: ___________

Special Needs:

Thanks and have a blessed day!