RCAR, Inc ~ ADOPTION APPLICATION

For the Dog, _____________________.

Last Name: ____________________________

First Name: ____________________________

Address: __________________________________________

City: ____________________________

State: _______ Zip Code: ________________

Phone: _______________________________

Cell Phone: ____________________________

Home Email: _____________________________________

If you have children that will be in contact with this dog please describe how they might interact with the dog and please include a list of children’s ages.

Your Veterinarian:

_______________________________________________

City: ________________________ State:____________

Phone: _________________________________________

Your Farrier: ___________________________________

City:  _______________________ State: ____________

Phone: _________________________________________

Character Reference Outside of Family:

_______________________________________________

City: _______________________ State: _____________

Phone: _________________________________________

Your Home/yard Information, please describe:

1. Size of Yard:

________________________________________________

________________________________________________

________________________________________________

2. Fencing: ________________________________________________

________________________________________________

3. Dog house/Shelter or allowed inside:

________________________________________________

________________________________________________

Will this adopted dog be kept with other pets? 

If so, please describe: Please attach list of each pet’s age, breed & sex to this application.

Number of other pets: __________________________

Explain where they are kept: ______________________

_______________________________________________

Please tell us more about your experience and intentions or purpose for the adopted dog.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

If we have no provided enough lines for information/descriptions please attach information on separate sheets of paper.