TAILS U WIN

Dog Rescue, Inc.

Phone 910-278-8879 Fax 910-278-7561 Email; tailsuwin@bellsouth.net

PRE-ADOPTION APPLICATION

Welcome to the Tails U Win Adoption Program. We’re glad that you are interested in adopting a new pet from us. The following information is requested, so that we can assist you in the selection of a new pet. The application process of a form and consultation with a Tails U Win representative, is designed to help us determine if the adoption is in the animal’s best interest, and to assist you in finding an animal most compatible with your lifestyle. Please fill out and give to a Tails U Win representative, or mail this form to Tails U Win, 133 NE 37^th St., Oak Island, NC.

Our adoption fee is $175.. This includes age-appropriate vaccinations, dewormings, Rabies vaccination, and spay or neuter. It also includes any medicines the pup may need while in our care.

In order to be considered as an adopter, you must:

have a vet recommendation
be at least 21 years of age
own your own home, or rent for at least 1 year at the same address
have consent of your landlord if renting and provide a copy of lease or letter from landlord
be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet

Please note !!! In order to be considered as an adopter for Pit Bulls, Rottweilers, German Shepherds, or Chows, you MUST :

be no less than 25 years old
have a fenced in yard, minimum height 4 feet
show knowledge of the breeds and the ability to give the care and training necessary for those breeds

Completion of this application does not guarantee adoption of a Tails U Win animal. Please print or type all information. Thank you!

Name of Applicant: ______________________________________________

Street Address: ______________________________________________

City/State/Zip: ______________________________________________

Area Code and Phone #: (_______) __________________ Work Phone # (___) _______________

Cell Phone # (______)__________Age ___________Email Address.____________________________

Describe in detail the animal(s) you are looking for: ________________________________________

__________________________________________________________________________________

Name of specific animal interested in at Tails U Win: _____________________________________

Would this be your first pet? __________________________________________________________

How many dogs/cats have you had in the past? ___________________________________________

Which of these do you still have (include name, age, sex and breed)? __________________________

__________________________________________________________________________________

Have they been spayed or neutered? ____________________________________________________

What happened to the ones you no longer have? ___________________________________________

__________________________________________________________________________________

If you have pets, will they/it adjust to a new animal in the house? _____________________________

Why do you want this animal? Personal/family companion Companion for other pet

House pet Watch dog Guard dog Hunting dog Personal protection Other

How many adults are there in your family? _____________ How many children? _______________

Children’s ages: ____________________________________________________________________

Does any member of your household have an allergy to animals? _____________________________

Is someone home during the day? ____________ Who? ___________________________________

How many hours each day will the animal be alone? _____________ Explain: _________________

__________________________________________________________________________________

Which do you live in: House Apartment Condo Mobile Home Other:

Do you own or rent your home? Own Rent

If you rent, may we contact the owner to obtain permission for this animal to live in your home? Y / N

Owner’s name and phone number: ______________________________________________________

Will you keep the animal up-to-date on vaccinations? _____________

Are you financially able to provide monthly heartworm preventative? ____________________

Employer _____________________________________ years with this employer _______________

Employer, Spouse_______________________________years with this employer_______________

Who is your veterinarian? ____________________________ City/Town: _____________________

Phone #___________________________May we call your veterinarian to get a recommendation? ______

If you go away for a few days, or on a vacation, who will take care of the animal? ________________

__________________________________________________________________________________

If you move, will you take the animal with you? __________________________________________

Have you ever applied to adopt a dog from Tails U Win or any other shelter in the past? Y / N When? __________________________ What animal? __________________________ If Yes, were you approved for adoption from any other shelter? Y/N

Have you ever asked Tails U Win, or any other shelter to take an animal? _______ If yes, please explain: _____________________________________________________________________

Are you willing to have a representative of Tails U Win come to see where the pet will be living? Y / N

Are you willing to take the responsibility for this pet for the next 10-15 years? ___________________

Do you have a completely fenced yard (all 4 sides)? ____________ Height of fence: ________

What kind of fence? ____________________ Is there a gate to the outside? ________________

What type of latch or lock? __________________________ If no gate, explain: ________________

If you drive a pickup truck, would you allow the dog to ride in the back? _______________________

Do you presently let any pets ride in the back of a pickup? ___________________________________

Would you be able and willing to exercise the dog on a regular basis? __________________________

Method: ___________________________________________________________________________

Where will this pet be kept during the day? _______________________________________________

During the night? ___________________________________________________________________

Comments by applicant: ______________________________________________________________

Signature of Applicant Date

_______________________ _________________________

TO BE FILLED OUT BY TAILS U WIN AFTER CONSULTATION

Application for adoption ! Accepted ! Denied

Comment: _________________________________________________________________________

Applicant Notified: ! Phone call ! Consultation

Tails U Win Representative: ________________________ Date: ___________________