Something Special Castaways Rescue Adoption Application

Who are you interested in adopting?
Adopter's Name
City, State & Zip
Home Phone
Cell Phone
Email Address
Today's Date
Do you own or rent your home?

What type of dwelling is it?

If you rent, are you allowed pets?

If so can you provide landlord contact info?

Is yard fenced?

What type of fence?
How many people live in the home?
Ages of any children living in the home?
Is everyone in agreement with adotping?

Does anyone in your home have a medical or allergy condition?

Who will be the primary caretaker of the animal?
Who will care for the dog in your absence?
Describe your ideal pet.
List your current pets, name, age, breed, altered....
List previous pets, name, age, breed, why no longer with you.
Were the above pets vetted?

Have you ever relinquished a pet to a shelter or other person? if yes, why?

Vet Name, city and phone number.
Do you give SSCR permission to call and verify your vet reference?

Where will your new pet be living?
How many hours a day/night will the pet be left alone?
How much time will your pet spend outside on a regular basis?
Where will the dog be kept when you are not at home?
How do you plan on exercising the dog?
Do you plan to enroll in obedience training?

Rescue dogs sometimes require extra time to adjust to a new environment, how much time do you feel is reasonable for this?
What will happen to the dog if you move?
Who will care for the animal if you can no longer care for it?
What behaviors would you be UNABLE to tolerate? (check all that apply)

What methods do you plan on using to discourage unwanted behavior? (check all that apply)

For what reason would you consider giving up your pet?
Why have you chosen to adopt a pet? Please be honest, we want to be sure that we can match you up with a pet appropriately.
Why do you want this pet? (check all that apply)

What are your feelings on spay and neuter?
Are you aware that animals require yearly vaccinations/test and the costs can be a minimum of $200

How long have you been looking for a pet?
Have you applied elsewhere?
What is the status of your other applications?
Are you aware that rescue dogs may have unknown medical or behavior history?

Would you object to SSCR calling or visiting you to inquire about the adopted pet?

Any additional info that you feel would be helpful?
Name: Serves as your electronic signature
Image Verification
Please enter the text from the image
[ Refresh Image ] [ What's This? ]