Tender Heart Canine Rescue

Adoption Application












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Please know that this application or any of these questions are not meant to push you away form adopting and animal by any means. We just want to make sure that these rescued babies are forever loved and taken care of. We assume that, if you are adopting rather than buying, but we must know the atmosphere that these animals could be living in. This application will not be shared with anyone, only our adoption coordinater will see the information on the application and no information will be given out to anyone about you.
 
Thank you for your understanding and you concern for the animals. We will pace the adoption process and quickly as possible.

What animal are you interested in adopting
Full Name
What is your date of birth
street address
City, State, and Zipcode
Home Phone Number
Cell Phone Number
Work or Alternate Number
E-Mail Address
Who Do You Live Withspouse
Roomate
Parents
Alone
Do you have Children in your homeyes
no
Please List The Ages Of The Children In Your Home
How Many Adults Live In Your Home
Does Everyone In Your Household Want This Animal yes
no
Does Anyone In Your Household Have Allergiesyes
no
If Yes, Please Explain What Allergies
Do Your Rent Or Own Your Home?rent
own
If You Rent Please Provide Your Landlords Name And Phone Number
If You Rent What Are The Guidelines For Owning An Animal ?
Do You Live In Anhouse
apartment
Condo
Do You Have a Fenced In Yard?Yes
No
How Tall Is Your Fence3 feet
4 Feet
5 Feet
6 Feet
8 Feet
What Type Of Fence Do You HaveChainlink
Farmfence (welded Wire)
Privacy
Do You Have Other AnimalsYes
No
If You Have Other Animals Please List Their Names, Ages, Species, Breed, Sex, Are They Spayed Or Neutered, And Up To Date On Their Shots
Are Your Current Dogs On Heartworm Preventative? If So What Brand?
If You Have Had Animals In The Past What Happened To Them
If You Answered Other To The Previous Question Please Explain
Please Supply The Name And Phone Number Of Your Current Veterinarian
This Animal Will Be
How Will You Exercise Your Pet?
How Long Will This Animal Be Home Alone?
Where Will This Animal Stay When You Are Gone?
Do You Have Any Experience With This Breed?Yes
No
If You Are Interested In Adopting A Pit Bull Or Any Other Bully Breed Please Tell Us Why?
Are You Willing To Work With Any Issues That This Animal May Develpoe?
Excluding Your Death Or Severel People Agression What Would Cause You To Return This Animal?
Please Provide 2 Names Phone NUmbers and E-mails of People That You Would LIke to Use As Personal References
Do You Understand That Any Animal Adopted From Us WILL Be Spayed Or Neutered Before Being Adopted?
Are You Aware That Each Animal Has An Adoption Feeyes
no
Are you willing to provide any and all annual medical care and emergency treatment that this animal may require for the rest of their lives?Yes
No
By Checking Yes, you agree to absolve Tender Heart K9 Rescue, and all of its representatives from any and all liability in reference to any dog featured on this websiteYes
No
Do you agree to make every effort that you can to make this adoption work?
Do you have any questions or comments about the adoption of any animal from us?