RAT TERRIER RESCUE CANADA ADOPTION APPLICATION FORM

Please cut and paste this form into an email and send to RTRC Applications

Application For:   (Insert dog name that you are applying for)

Name:                                                                                                                    Age:

Spouse:                                                                                                                 Age:

Address:  

City:                                                                         Province/State:    Postal/ZIP Code:

E-Mail address:

Home phone:                 

When is a good time to phone you?

How long have you lived at this address? 

Please indicate which best describes your current living situation:
House        Condo             Apartment            Mobile Home      Rent       Own       Live with parents

If you rent, name & phone number of landlord:

What type of environment?       City              Suburban            Country

If less than two years, please list your previous address:

Your employer:                      Phone:

Job title:

How long employed there:

Spouse's employer:                Phone:

Job title:

How long employed there:

Your children and their ages:

Besides your immediate family, are there others residing in your home? 

Names:                                                                                                                                 Ages:    

Does your home have a yard?  

Is there a fence?                 

What type of fence and how tall?  

Locked gate?

Do you have invisible fencing?

Is the fence secured underground as well?

Do you own a Pool?

If yes, is it fenced? 

Above or in-ground?

ADOPTION INFORMATION

Have you owned a Rat Terrier or other terrier in the past?
What appeals to you about Rat Terriers?
Are you familiar with the typical personality and temperament of a Rat Terrier?
Is someone home during the day?
If no, where will the dog stay while you are gone? 
Where will your dog be kept most of the time?  For example, in house, outside, basement:
Will you have a dog run/dog house? 
Will you take your dog to obedience class? 
Which trainer do you plan to use?  
Have you ever owned a dog?                                           

If yes, where is that dog now?
Do you prefer a male or female dog or it doesn’t matter?                                          Age range?
If the dog you are applying for is no longer available, is there another dog you are interested in within Rat Terrier Rescue Canada or would you like us to keep your application on file?
Why do you want a rescue dog?
What activities do you plan to do with your dog?
How many years do you plan to keep the dog?
Under what circumstances would you give up your dog?

OTHER PET INFORMATION
Do you have other pets?                    Type (list breed, age, sex):
Are your other pets current on all vaccinations?
If yes, approx date of pet's last office visit: 
Are your other pets spayed/neutered?
Are your animals on heartworm preventative and if so, what type?
Veterinarian's name & phone number:
Name that animals are under at the vet's office (pet's name and owner's name)

List the pets have you owned in the past ten years and what happened to them:

OTHER INFORMATION

How did you hear about Rat Terrier Rescue Canada? 

List any humane societies, organizations, breed or training clubs you are associated with:

We will attempt to provide you with an honest evaluation of the temperament on any dog we have to place. Do you realize that often times the complete history of a rescue dog may not be known and you may encounter some behavioral problems?     Yes   ___________         No ___________    

Are you willing to work with us on correcting these problems?       

Please provide the name, relationship to you, address and phone number of three references:
(1)

(2)

(3)

I certify that the information provided on this form is true & correct. In emailing this document I am granting permission for a Rat Terrier Rescue Canada Representative to contact all stated references & veterinarian(s).  I am also financially and physically able to care for this animal. I understand that proper food, water, shelter, and veterinarian care is necessary & may be costly, and I am able to meet these requirements. Home visits are mandatory prior to adoption and are made on a random basis following adoption. If upon inspection we find that information contained in this application to be false, we retain the right to turn down your application or remove the animal from your premises without a refund of moneys paid.  We reserve the right to refuse an applicant due to our primary interest being the well being of the animal.   We require our RTRC Adoption Placement Contract signed prior to adoption, certifying the above information