Please complete the entire Dog Adoption Form. *Required Field Please enable JavaScript in your browser to complete this form.Dog's Name *Your Name *Email *Phone *Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNumber of Adults in home: *Ages *Number of Children in home: *Ages: *Why do you want to bring a new dog into your home? *Is everyone in the household in agreement on adopting a new dog? *When will you be ready for your new dog? *Type of housing: *HouseApartmentCondoTownhouseHow long have you resided at your present address? *Do you own or rent? *OwnRentLandlords Name:Landlords Phone:Are Pets allowed? *YesNoDo you have a yard? *YesNoWhat size?Is the yard fully fenced?YesNoFence HeightAre you planning to change residence in the near future? *YesNoWhere will your dog be exercised? *How much daily exercise will you provide (explain)? *How long will your dog be left alone during the day? *Where will your new dog be kept while alone? *Do you own a crate? *YesNoHave you ever crate-trained a dog? *YesNoWill you be crating your new dog? *YesNoDo you understand that your new dog may develop some issues as it adjusts to its new home? *YesNoWill you tolerate the following issues during that adjustment period? *Housebreaking accidents? *YesNoChewing? *YesNoBarking/whining? *YesNoIf these issues do not get resolved in a reasonable amount of time, what will you do? *What do you consider a reasonable amount of time? *Have you ever taken a dog to obedience training? *YesNoWill you attend training classes with your new dog? *YesNoHow long have you been searching for a new dog? *Where have you searched? *Why did you choose this particular dog? *Does anyone in your household have any known allergies to dogs? *YesNoIs anyone in the household fearful of dogs? *YesNoHas anyone in the household ever been bitten by a dog? *YesNoPlease explainList any animals you currently have, include name, age, breed, sex & s/n: *List any animals you have had in the past, include name, age, breed, sex & s/n: *How long did you own the pet/s? * *Why do you no longer own the pet/s? *Has any pet of yours ever been lost? *YesNoPlease explainHit by a motor vehicle? *YesNoPlease explainVeterinarian Information for current &/or previous pets:Please call your vet’s office and let them know we will be calling for a reference and that it is fine to give us information. This will expedite the process.Name *Address *Phone *A dog can live 12-18 years. Are you financially prepared and willing to give this animal the medical care it requires for its lifetime? *YesNoPlease list 2 references (non-family members)a) Name *Relationship *Email *Phone *b) Name *Relationship *Email *Phone *CheckboxesRawhide Rescue welcomes a partnership with Hill’s Pet Nutrition whereby Hill’s provides us with Hill’s Science Diet to feed our rescued dogs. In agreement with Hill’s we will provide them with the contact information of our Adopters who benefit by receiving coupons, etc. from Hill’s Pet Nutrition, Inc. Please indicate here if you DO NOT want these promotional materials sent to you by Hill’s Pet Nutrition, Inc. Permit Rawhide Rescue volunteers to conduct a home visit upon placing the dog and follow up calls for the purpose of assuring the proper care and adjustment of the dog. In the event you cannot keep the animal, you MUST IMMEDIATELY contact Rawhide Pet Rescue at 908-581-3417or e-mail at rawhiderescue@hotmail.com Purchase an identification tag for your new dog within the first 24 hours of possession. Notify us IMMEDIATELY if the animal becomes missing or lost so we may assist in finding it. Accept possession, title and responsibility of the animal described above at your own risk, and hereby release and waive any right against Rawhide Pet Rescue which you may have now, or in the future, for any damages to person or property caused by said animal. Recognize that animals, like humans, differ in their responses to different situations and that we cannot make any claims or representations as to previous or future behavior and actions of the animal. Have the animal checked by your veterinarian within 7 days. Provide medical care at your own expense of any conditions previously unknown to Rawhide Rescue as well as routine yearly exams for as long as you own the dog. IN SIGNING BELOW YOU AGREE TO ALL OF THE TERMS ABOVE AND UNDERSTAND THAT IF YOU HAVE GIVEN FALSE OR MISLEADING INFORMATION OR DO NOT FOLLOW THE TERMS OF THIS CONTRACT, ANY OF THE ABOVE AS INDIVIDUALS OR AS AN ORGANIZATION MAY RECLAIM THIS ANIMAL AND START LEGAL PROCEEDINGS AGAINST YOU, AT YOUR EXPENSE, AND MAY ASSESS DAMAGES IN THE AMOUNT OF $1000.00 AGAINST YOU. YOUR FAILURE TO COMPLY WITH ANY OF THE ABOVE TERMS OF THIS AGREEMENT WILL RESULT IN THE ANIMAL RETURNING TO ANY OF THE ABOVE-MENTIONED OR THEIR REPRESENTATIVES. RAWHIDE RESCUE RESERVES THE RIGHT TO RECLAIM THE ADOPTED ANIMAL IF THE ANIMAL IS NOT BEING TREATED HUMANELY OR IS ABUSED. THIS WOULD INCLUDE BUT IS NOT LIMITED TO INADEQUATE FOOD, WATER, SHELTER, SOCIALIZATION, AND EXERCISE. Rawhide Rescue reserves the right to reclaim the adopted animal if the animal is not being treated humanely or is abused. This would include but is not limited to inadequate food, water, shelter, socialization, and exercise. Rawhide Rescue also reserves the right to deny adoption of a puppy to a family with young children under the age of six years old. I HAVE READ, UNDERSTAND, AND WILL COMPLY WITH ABOVE STATED CONDITIONS.Signature *Typing your name here serves as your signature of agreementCLICK HERE TO SUBMIT APPLICATION