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Little Rhody Rescue & Quarantine Services ~ pooches on the Move Adoption applicationPlease Note: We are committed to matching the right dog to the right family so all will have many happy years together. Our adoption process includes the completion of an application, phone interview, veterinary reference, adoption fee and contract. We understand that it might seem to some to be ‘over the top’, but we are striving to make yours the last home they will ever need.? The standard adoption fee is?$500, and will be billed to you via Pay Pal after your application is approved.? You must be at least 18 years old to submit this application.? The application is the first step in the process and can be submitted via email to?LittleRhodyRescue@.We are the voice of the animals in our care.? If we are asking personal or sensitive information, it is for the sole purpose of assuring that this is a great pet for your home and lifestyle. As a group, we have been perfecting our rescue for 12+ years. Over EIGHT THOUSAND adopting families will agree. We are doing it right!? ALL animals are spayed and/or neutered. There will be no exceptions to this rule. Overpopulation is the #1 reason for us to exist. ? All animals are current on their vaccinations, wormed, and transported for the standard fee. Little Rhody Rescue and Quarantine is a class?“A”?rescue. We are also the only?residential quarantine service registered and approved by the state of RI DEM. Our license numbers are:??RI (Class A) License 928/696Quarantine Services License # 942/707Pet store Puppies are PUPPY MILL PUPPIES !!! ?Thank You for considering adoption; it’s the responsible option!ADOPTION APPLICATIONDate ________________ Name of Desired Pet:? _______________________First Name:____________________ Last Name: ______________________Street Address: __________________________________________City: ______________________________ State:_________ Zip: _______________Home Phone:______________________Cell/Other Phone________________________________________________Email Address: ______________________________________________Best Time To Contact: __________________________________________?? ?Place of Employment:__________________________________________?? ?Work Phone:?Do you own or rent your home? ? ? ? RENT? ? OWN? ?How long at current residence??If you rent, has your landlord provided written permission for you to have a dog?? YES / NO? ? Landlord name and Phone ________________________________________________Please list?all?members of your household:? ?HUMANS (names & ages)_____________________________________________________________________________________________________________DOGS?(name, gender, age, breed, altered?): __________________________________________________________________CATS?(name, gender, age, breed, altered)________________________________________________________________________________________________ OTHER PETS (name, type, age) ______________________________________________________________________________________________________Please list your Veterinarian (provide name & Phone number)________________________________________________________________Do all household members want to adopt a dog? ? YES / NOIf there are no young children living in your home, will your rescue dog have regular contact with any under the age of 10?? YES / NO? ?If yes, describe?If there are no other animals currently living in your home, will your rescue dog have regular contact / socialization with others? YES/ NO ?If yes, describe?PREFERENCES OF RESCUE DOG YOU WOULD LIKE TO ADOPT:AGE:? ? ? Pup ? ? ? Young (1-3Y)? ? ? Adult 3+? ? ? Senior ? ? SEX: Male / FemaleSIZE: Small <25 / Medium 26-50/ Large 51-99 / Extra Large 99+Hair/ Fur coat preference? ? ? ? ? ? ??_______________________________ ACTIVITY/ENERGY LEVEL:?Low / Medium / HighSpecific BREED or MIX:??? ??COLOR:?How active are you/your family?? __________________________________________________________________________________________________________?Do you have a fenced (or Electric Fence) yard? ? ? ? ? Yes/ No? ?If yes, please describe:?If you don’t have a fence, are you willing to install one?? Yes/ No? ?Does anyone in your household have allergies or asthma?? Yes/ No? ? If yes, who/kind??____________________________________If you do not currently have a dog, have you ever owned a dog in the past for which you were the primary caretaker?? Yes/ No? ?If yes, what happened to the dog??Have you ever sold, given away, surrendered or put down a pet?? Yes/ No? ?If yes, please explain:?How many hours per day will your dog(s) be home without humans on a regular basis??______________________________________________________________Where will the dog(s) be when you are not home??_____________________________________________________________Are you familiar with the use of a dog crate to train and/or confine the dog during your absence or at night?? Yes/ No? ??? ?Are you planning to use a crate?? Yes/ No? ?What will you do with your dog(s) if you need to be away from home overnight?______________________________________________________________________________________________________________________________________________?? ? ? ?______________________________________________________________________________Are you aware that costs of maintaining a dog can average $500 or more a year (food, annual checkups & shots, heart worm & flea/tick prevention, grooming, etc.)?? YES / NOWill the rescue dog…..?be tied outside?? YES / NObe walked daily? YES / NO??be allowed to run free outside of a fenced yard? YES / NO?have annual vet check-ups?? ? ? ? ? ? ? YES / NOreceive formal obedience training? ? YES / NOIf you move, what will you do with your dog(s) and other pets? ____________________________________________________________________________________________________________________________________________________________It is IMPERATIVE that you notify Little Rhody Rescue?at the onset?of any type of illness or health problem within 30 days following this adoption.?Do you promise to tend to this if there should be an illness or issue?? YES / NOWhat would you do if one of your pets requires significant medical attention??_____________________________________________________Would you consider a special needs or handicapped dog that may require medication for a permanent (but controllable) condition?? YES / NOAnything you would like to add? Additional space may be added here/ on the back should you wish. ??_______________________By signing below, I/we understand that this is the first step of the adoption process.? I/we attest that the information provided on this application is true and accurate to the best of my/our knowledge and that I/we are 18 years of age or older. I/we understand that completion and submission of this application does not guarantee or entitle me/us to adoption of a rescue dog. Intentional omission or misrepresentation of information will void the process entirely.Applicant’s Signature: ____________________________________________Date:Co-Applicant’s Signature: ___________________________________ Date:______Give a first rate dog a second chance~?ADOPT!spay~ neuter~ spay~ neuter ~spay ~neuterKate ?Healey DubuqueLittle Rhody Rescue, Quarantine& Pooches Cooperative401~692~1117RI State?License 928/696Quarantine facility License 942/707Give a first rate dog a second chance~?ADOPT!spay~ neuter ~ spay~ neuter ~spay ~neuter ................
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