Welcome to RR

Find Your Match-Dog

Thank you for the interest in adopting a dog from Rocket Rescue! If you are pre-approved for a dog adoption, this form will allow you to be placed on a wait list for a dog that meets your interests (e.g. breed, age, size, etc.). You will be contacted by a foster home if an appropriate dog enters our program. This form does not guarantee an adoption or require you to adopt, but it will allow us to contact you directly if we find a potential match.

Contact Information

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
-

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email

*=required

What breed or breed mix are you interested in?*

Is there a certain size or weight limitation (e.g. 25 lbs and under, 26-60 lbs, 61 lbs and up, etc.)?*

What ages are you interested in (e.g. under 4 months, 4 months to 1 year, 1 to 2 years, 3 to 6 years, 7 and up)?*

Do you have a preference for male or female or would you consider either?*

Anything else we should know about your perfect dog match?*

Do you rent or own your home?

If you rent, do you have a pet agreement? Please provide your landlord's name and contact information.

Please describe your home (stairs, flooring, size, pet areas, yard, etc.).*

What type of home do you live in (house, apt, condo, mobile, etc.)?*

Is your yard fenced? Please describe the fence (include height).*

If you do not have a fence, how do you plan to contain the dog?

Please list the age and number of household members.*

Please provide your employer information.*

Do children visit your home regularly?

Yes

Are you a first time pet owner?

Yes

If you have other pets in your home, are they all spayed or neutered?*

Do you have other pets? If so, please list other pets by species, age, and gender.*

Have you ever surrendered a pet?

Yes

Why are you interested in adopting this dog?*

Who in the household will care for the dog?*

Where will the dog spend most of its time?

Inside Only	Inside/Outside
Outside Only

How long will the dog be alone during the day?*

Where will the dog be kept when you are not at home?*

Where will the dog be kept at night?*

What traits are you looking for in a dog?*

Are there any behaviors you will have a hard time dealing with? Please explain.*

Describe how you will train the dog.*

What is your plan if you can no longer care for this dog?*

Please provide your veterinarian's name and contact information.*

Please provide a name and contact information for at least one reference. *

Would you object to a Rocket Rescue representative visiting your home? If yes, please explain.*

I certify that all the information provided in this application is true and accurate. Enter your name and date.*

*=required