Return to Donna White at dmwzeus@yahoo.com or DJ Freeman at grrrescue@yahoo.com
or mail to Grand River Rover Rescue, 8444 Evelyn Drive, Lyons, MI 48851

Are you applying to (check one) Adopt___ Foster___ Undecided at this time ____

Which pet are you interested in?: ________________________________

Your Name: ________________________________ Spouse’s name: __________________________

Address:____________________________________________________________________

Daytime Telephone: ______________________ Evening Telephone: ______________________

Email Address if any: ____________________________________________

Please list any children in the home: Name / Age
__________________________________________________________________________________________ __________________________________________________________________________________________

Do you own your home, rent or live with friends or relatives?__________
If you rent, a copy of your lease stating pets are allowed must be enclosed.
If you live with relatives or friends, a letter from them giving permission for a pet must be given.

Do you have a fenced yard? ______ How high is the fence? _______ Type of fence:____________
If no fencing, how will the dog be secured when outside for potty breaks, etc. ?
Tie-out____Kennel____Overhead trolley system____“invisible” fencing____Other: _____________

How long each day on the average, will the animal be left home alone?___________________
Where will the dog be kept when no one is at home?_____________________________________
Where will the dog be kept at night?__________________________________________________
Do you have or are you willing to get, a dog crate for use in the home? __________
(If you are not familiar with the use of crates, please talk to us about it)

What pets do you have or have owned in the last ten years:
Name/Species/Spayed-Neutered?/Do you still have? If not, what happened to it.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Please fill in the following, whether past or present. Include all if more than one doctor was used:
Name of Veterinarian1:______________________ Name of Veterinarian2:_____________________
Address: _________________________________ Address: _______________________________
Telephone: _______________________________ Telephone: ______________________________
Name of pet(s) seen there:___________________ Name of pet(s) seen there:____________________
Name of owner on the vet’s file:_______________ Name of owner on vet’s file:__________________

Do we have your permission to call these veterinarians for a reference?______(initial)___________

If you adopt this animal, what vet will you take the new pet to? Same as above____#1 ____#2

Name of Veterinarian: _________________________________________________________

Address: _______________________________________________________

Telephone number of clinic_______________________________________________

Do we have your permission to call the above named vet you indicated you will be using for this pet for the purpose of following up on this adoption? __________ (initial)_____________

Which family members will be responsible for daily care such as food, water, exercise, potty breaks?_______________________________________________________________________

What type / brand of dog food do you use or plan to use for this dog?__________________________________________________________________________

Which family members will be involved in training the dog? (Obedience, housebreaking, etc.)__________________________________________________________________________

How will you handle housebreaking accidents?_____________________________________________________________________

How will you handle chewing, digging, barking, jumping on people behaviors if they occur?________________________________________________________________________

Do you plan to take the dog to obedience classes? Where would you take them?__________________________________________________________________________________________

If there are other pets in the home, introducing the new pet will take some time to be done in a way that helps to ensures success. Can you handle a gradual introduction period of two weeks that will involve not leaving the pets loose together, unsupervised, during that time? __________

Why do you want a dog? Why do you want this dog in particular?_________________________________________________________________________________________________________________________________________________________________________________________________________________________________

1. Can you commit to paying for HeartWorm medicine for at least nine months out of the year, flea preventatives for at least 4 months and an annual heart worm test each spring? __________

2. Have you checked the prices of these products through your vet? __________

3. Can you commit to a rabies booster shot every one/three years and a combination booster vaccine (DHLLP shot) annually? __________

Do you accept the fact that we can not guarantee the health, the history or the specific breed of the dog/cat you are interested in adopting or fostering and agree to hold harmless the rescue, shelter and all volunteers for any behavioral problems, health issues that exist or may develop at any time before, during or after the adoption or foster experience?_________ (initial)_____________

In signing this application you are agreeing to indemnify and hold harmless the directors and volunteers of Grand River Rover Rescue, Rolling Rescue, Lakeside Pet Kennels, and any of the other agencies, vendors or donors involved with this project against all claims of injury, damages, loss, illness to any persons, pets and property related to your adoption or fostering of one of the animals placed in your care. (initial)_____________

If, at any time, you come to the decision that you cannot keep this pet, you will contact one of the above listed organizations, or persons, to reclaim possession and rehome the pet. (initial)_____________

Furthermore, if submitting this application and entering into this agreement as a foster home , you acknowledge that the animals placed in your home and care are not your property and until such time as an adoption contract is executed, the individuals working as members of Grand River Rover Rescue retain ownership of the dog. You agree to keep us informed of the animals whereabouts, surrender the dog promptly if asked to, and to keep us informed of any problems of any kind that you encounter. (initial)_____________

Thank you for your interest. You will be contacted for an interview and if we are in mutual agreement to proceed with the adoption or foster arrangement, a home visit will be scheduled by one of our volunteers. In the event that you decide you wish to adopt the animal and take permanent responsibility for the animal, a separate adoption contract will be executed.

Signature of all adult members of the household and date:

(Primary adopter)_________________________________________________ Date_______________

Other adult household member_______________________________________ Date_______________