Connections Pet Rescue

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone*
x

Cell Phone*

Alt Email*

What is your age?

Secondary Applicant's Name:

Secondary Applicant's Age:

How many people reside in your household?*

Age of children (if any)? Please include visiting children and/or other children the dog may be interacting with.*

What is the activity level in your home?*

Please list any disabilities/special needs of anyone in the home (or regular visitors) that it may be helpful for us to be aware of.

How did you hear about us? (IF on a computer, please hold the "Control" key down while selecting multiple options.)
Choose all that apply: CPR Facebook CPR Website Instagram Petfinder Reddit TikTok Referral Twitter

What is your occupation? Please state also if full-time or part-time, retired or student.*

Do you rent or own your home?

In what type of home do you live?

If you rent, please enter your landlord's name and phone number

If you rent, have you received the approval of your landlord to have a large breed dog?

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What is the height of the fence*

What type of fence*
Choose one: Privacy Chain Link Invisible

Have you had any pets in the past 5 years?

Veterinarian's name, phone number and the name of the person records are under. Please make a note if you do not currently have a vet.

Please give us information on each animal separately. Please choose the type of your first animal.

Please tell us about your 1st pet's NAME, BREED, AGE, and GENDER:

Is this pet spayed / neutered?

Where did you get this pet?

Do you still have this pet? If not, what happened to it?

Please choose the type of your second animal:

Please enter your second pet's NAME, BREED, AGE and GENDER:

Is this pet spayed or neutered?

Where did you get this pet?

Do you still have this pet? If not, what happened to it?

Please choose the type of your third animal:

Please enter your third pet's NAME, BREED, AGE and GENDER:

Is this pet spayed or neutered?

Where did you get this pet?

Do you still have this pet? If not, what happened to it?

If you have other additional pets, please list them here - and include their names, breeds, ages and genders:

If it has been longer than 5 years since you have owned a dog, but you DO have dog experience, please give details on what this experience was.

If in the past 5 years, you currently have only small dog experience, do you have any large breed dog experience that you could give details about?

Have you ever given up a pet? If yes, please explain:

If applying to adopt a puppy, please explain your philosophy on whose responsibility is it to make sure a puppy that is 11 months old or younger does not grow up to be aggressive?

If you were approved to adopt a puppy (up to 11 months old) from CPR would you return the puppy if the puppy became aggressive as an adult?

Please explain your knowledge of socialization, dog behavior, and proper integration & rearing of a puppy or rescued adult:*

What is your definition or philosophy of disciplining and training your dog?*

Have you attended obedience classes before?

Have you crated your dog in the past?

Are you willing to housebreak a dog?*

Will your dog be kept inside or outside?

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

How much time will the dog spend alone during the day?

Please tell us if you have had experience with any of the following behaviors: Counter Surfing

Experience with aggression toward other dogs?

Experience with barking?

Experience with chasing cats or other smaller pets?

Experience with housetraining accidents?

Experience with resource guarding?

Experience with shyness toward strangers?

Experience with separation anxiety (whining, destructiveness or acting out when left alone)

Experience with inappropriate chewing?

Experience with leash pulling?

Experience with fence jumping?

Name of dog(s) that you're interested in adopting. Dogs marked "pending" have an adoption in process. It is possible that a dog you are interested in may not be a good match or could be adopted before your application is approved. Your adoption coordinator will recommend other choices.
Choose an animal: Haku Lobo Sierra Smith

What is your second choice for the dog you are interested in?
Choose an animal: Haku Lobo Sierra Smith

If the dog does not appear in the dropdown menu, type the name here

Age preference
Choose all that apply: Puppy under 6 months 6 months to 2 years 2 to 5 years Over 6 All of the above

Gender preference:

Would you consider a dog with special needs such as blindness, deafness, physical limitations etc?

What is your breed preference?

What level of activity would best suit your family
Choose all that apply: Low Medium High

What other characteristics are you wanting to have in your dog?

Have you applied with other rescues?

Are there characteristics that may cause you to return a dog - and please explain all of your selections in detail:*

Please add anything that you think we should know here:

By submission of this application I(we) attest that the information provided on this application is true and accurate to the best of my(our) knowledge. I(We) understand that completion and submission of this application does not guarantee adoption of a dog from Connections Pet Rescue. I(We) hereby permit Connections Pet Rescue to contact my(our) Veterinarian(s) and Landlord, if applicable. Please initial.*