North Carolina Rescue League

Home
Application for Adoption
Success Stories
Events Calendar
Login

Application for Adoption

Name:

Home Phone

Work Phone

Email

Occupation

Home Address 1

Address 2

City

State

Zip Code

Years at Address

Months at Address

Do you Rent or Own? Rent
Own

If you rent, do you have landlord\'s permission to own a pet? Yes
No

Landlord Name

Landlord Phone

Do you have a fenced back yard? Yes
No

If yes, is it attached to the house? Yes
No

Do you have a pool? Yes
No

May we visit your home? Yes
No

When?

Do you have children in your household? Yes
No

List the ages of all children in your household

Are you planning on having children? Yes
No

Are there any other people in your household? Yes
No

Does anyone in your household have any allergies? Yes
No

Who is the dog for? (Primary Caretaker)

Why do you want a dog?

Which dog are you interested in?

Do you have a second choice?

If no specific dog, do you have a breed preference?

Gender Preference Male
Female

Would you accept a mixed breed? Yes
No

Would you accept a dog with special needs? Yes
No

Are you planning to crate train? Yes
No

How are you planning to exercise the dog?

Please provide us with some information about your lifestyle

Where would the dog be kept during the day?

Where would the dog be kept during the night?

Where would the dog stay if you go on vacation?

If you have to move, what would happen to the dog?

Are there any behaviors, or reasons, for which you would give up the dog?

Do you have other pets? Yes
No

Number of dogs? Breed/Name

Number of cats? Names

Number of other pets? List please

Are they all current on vaccines and on heartworm and flea prevention? Yes
No

If you have pets, please give us the name of their Vet?

Vet Phone

do we have permission to contact your vet if applicable? Yes
No

Do we have permission to contact your landlord if applicable? Yes
No

Sponsor a Rescue Dog

Baylee

Benji

Bobby

Brewster

Ellie

Harry

Application for Adoption

Baylee

Benji

Bobby

Brewster

Ellie

Harry