Apple Canyon Critters Rescue

Orangeville, Ohio

Our major concern is the appropriate placement of good tempered, family oriented, community oriented animals into suitable life long homes. To this end we encourage the application of stable people who feel the need for and the desire to find a life long friend, a soul with whom they will spend much of their lives. We view the adoption process to be a discovery process where you, the potential life long guardian for the adopted soul, discover what you are looking for and where the adopted soul finds peace and a good life. Many of friends who are in need of homes have never had a gentle touch or a clean or well lighted place in which to live; they have never been cared for by any person very much and love and understanding are vital to a positive adoptive outcome. Without doubt, our homeless souls will love without reserve; our concern is whether you will love them without reserve.

APPLE CANYON CRITTERS ANIMAL RESCUE

APPLICATION TO ADOPT A COMPANION ANIMAL

Name of the companion you want to adopt: __________________
Date:

I. PERSONAL INFORMATION

Adopter’s name:

Street Address:

City/State/Zip:
Telephone numbers: Home:
Work(only if it is okay to call!): Cell:

Email address:

Other adult(s) in the home, their relationship to you & their names:

Number and age of children living in the house or visiting on a very frequent basis:

Do other children visit?

Your Age:

Your occupation:

Employer:

Occupation of spouse/other adults living in the home:

Does your entire household know that you are considering adopting an animal?

Is everyone in your household in agreement that the adoption of an animal is the correct thing to do at this point in time? If not, please explain.

II. WHICH DOG OR DOGS?

What particular dog or dogs that we have sponsered are you interested in?
Why?

III. WHAT KIND OF PET OWNER ARE YOU?

Why are you considering adopting a dog?

Where would the dog be primarily housed?

Where would the animal stay when you are not at home?

Are you planing on use of a crate, play pen, or baby gates? Just tell us your general thoughts with respect to this subject.

Where will the animal sleep at night?

Approximately how many hours each day would the animal be left alone?

Do you plan to have a sitter or use doggie day care?

Household setting:
Where do you live(townhouse, apartment,house)?

Do you own?

Describe your yard:

Describe your home’s activity level:

If you have children in your home, are your children active? Are they laid back? Will the animal be expected to tolerate a loud scene at home?

Rank the following factors in order of importance (with 1 being most important and 8 being least imporant) in your decision to adopt. If a factor listed below is not relevant, mark a zero beside the factor.

_____age of animal

_____age of children in the home

_____age of yourself

_____breed or mix in particular

_____activity level of animal

_____color of animal

_____sex of animal

_____size of animal when grown

Do you want a dog to act as a guard dog or human assistance dog or a therapy dog? If yes to any of these, please elaborate.

Do you feel that a pet should be spayed/neutered? Are your present and have your previous animals been spayed/neutered? If not explain why?

IV. IF IT DOES NOT WORK OUT, WHAT THEN?

What problems would make you want to return an animal?

Under what other possible circumstances would you return the animal ?

V. HOW ABOUT THE PETS YOU HAVE NOW OR HAD IN THE PAST?

Please list all animals that you presently own and have owned in the past.

Please give us the name and phone number of your veterinarian so that we may verify how well your animals are or were cared for :

Please provide us with the name and phone number of the groomer you use for your animals if you use a groomer.

VI. Apple Canyon Critter RESCUE PLANS TO MAINTAIN CONTINUING CONTACT WITH ADOPTIONS TO INSURE THE WELL BEING AND ADJUSTMENT OF THE PET. ARE YOU WILLING TO PERMIT TELEPHONE CALLS AND POSSIBLY HOME VISITS TO CHECK ON HOW THE ADOPTED ANIMAL IS ADJUSTING?

VII. IMPORTANT!
If at any time an adopter cannot keep the animal, it must be returned to Apple Canyon Critter Rescue. In addition, each pet adoption is assessed an adoption fee, varying by animal, to help pay veterinary and other expenses for all of the animals sponsored by the rescue. Adoption fees are nonrefundable. Should you have a question, please feel free to call our representative at 724-580-7048 or email Martin at applecanyoncritters@yahoo.com.
By signing below, I acknowledge that I have completely read this questionnaire, comprehend it fully, know that applying does not ensure approval, and that untruthful answers or failure to comply with the requirements of this application or the adoption contract can result in the forfeiture of any dog adopted by me from Apple Canyon Critters.

Applicant’s Name _________________ Date_____________