RAINCOAST APPLICATION FORM Your Information Please select the type of animal you're looking to adopt: Cat Dog Your Full Name Email When will you be able to welcome a dog or cat into your home? Cell # Your Age Home Phone Spouse's Name (If applicable) Spouse's Age Home Mailing Address If relationship were to change who would the dog or cat remain with? Your Past Animal History Your experience with animals? Please explain. Do you currently own any pets? If so, what breed, age, sex and if they are fixed. Please list all animals living in the household. Please be detailed and clear. Do you have experience with rescue animals? Please explain. If applicable. What is your current dogs/cats diet like? ie: Kibble? Raw? Cooked? Do you have any experience with large breed / powerful breed dogs? What type of diet do you plan on feeding your new dog/cat? How much exercise do you plan on giving your adopted dog on a daily basis? When you go to work where will dog stay? Are you willing to work with any behavioural issues? (ie. reactivity, separation anxiety, fearfulness, potty training etc.) Yes No Have any of your previous dogs have behavioural issues? if so, how did you address them? Home Information Who else lives in the household? Please include children’s ages. Who in the household works? (Full Time/Part Time) Do all the people living in the household want to welcome a rescue dog/cat into the home? Yes No Is anyone in the household allergic to dogs or cats? Residence Background Residence Type: Do you own or rent? Own Rent If renting, what name is the lease under? What is your relationship like with your neighbours? May we contact your landlord to verify permission for having a dog or cat? If yes, what is your landlords name and phone number? Do your neighbours own any dogs? Do they keep them safety fenced or indoors? About Your Yard Do you have a fully fenced in front-yard? Yes No Do you have a fully fenced in backyard? Yes No What type of fencing for the front and back? How high are the fences? About You Tell us a little about your lifestyle so that we may help pair you up with the right dog or cat. (Do you jog, have a lot of social activities at your house, couch potatoes, etc?) Under what circumstances would you chain up a dog? (Does not apply to cat applicants) Do you already have a veterinarian? If yes, who? Under what circumstances would you give up a dog or cat? Please list one other reference that is not a relative. Name, phone number and relationship to the applicant(s). Have you ever surrendered a pet before? Yes No What dog day cares (if any) have you used in the past? May we contact them for a reference? (Does not apply to cat applicants) About Your Potential New Dog I am interested in adopting a dog/cat that fits the following profile Please describe the ideal type of dog/cat you are interested in? Breed, age, sex, temperament etc? What characteristics made you choose this particular breed(s)? Are you aware that there is an adoption fee to be paid as a deposit in cash or via e-mail transfer the day you start the “foster-to-adopt” period with your new dog/cat? Yes No If you are interested in a specific dog or cat we have up for adoption? What is his/her name? If you are interested in fostering ONLY there are no fees involved, please indicate if this is your intent. Yes No Indoor or outdoor animal? indoor outdoor Do you understand that all vaccinations, flea and tick medication and dewormer is covered up to date of the adoption. The spay and neuter is also covered, unless there is extenuating medical circumstances. Then an independent contract agreement will be made. Yes No Where will the dog/cat sleep? Do you have any physical or mental conditions which may impact your ability to care for a pet? Yes No How much time will dog/cat spend home alone? How did you hear about RainCoast Dog Rescue? Is there anything else you would like to add? Send
