Date:
Please list the dog(s) you are
interested in adopting.
Applicant Information
Name:
Age:
Home Address:
Home Address 2:
City:
State:
Postal Code:
Home Phone:
Work Phone:
Cell Phone
Fax Number:
Email:
Preferred Contact Method:
Home Phone
Work Phone
Cell Phone
Email
Employer:
Employer Contact Information:
Position:
Please list the number of adults
and their ages in your household.
Please list the number of
children and their ages in your household.
Please list the names, breed,
sex, and age of your current pets.
Are all your current pets spayed
or neutered?
Yes
No
If your current pets are not
spayed or neutered, please include why.
Are your canine pets on any form
of heartworm prevention?
Yes
No
If so, what brand of heartworm
prevention are your canine pets taking?
Interceptor
Sentinel
Heartgard
Heartgard Plus
Revolution
Other
Are your pets on any form of
flea and tick prevention?
Yes
No
If so, what brand of flea and
tick prevention are your pets on?
Advantage
Advantage Multi
Bio Spot
K9 Advantix
Frontline
Frontline Plus
Hartz Control
Other
Do you live in a(n):
Single Family Home
Townhouse/Brownstone
Apartment
Condo
Other
If other, please explain:
Do you own or rent your home?
Own
Rent
How long have you lived at your current
residence?
If you rent, do you have permission to have a
dog/pet?
Yes
No
Please provide you Landlord's Name:
Please provide your Landlord's
phone number and contact information:
Do you have a yard?
Yes
No
Is your yard fenced?
Yes
No
Please provide a description of
your yard and fence, including size estimations:
How will you handle daily
exercise and toilet duties?
Would your adopted pet ever be left outside
in the yard without supervision?
Yes
No
The following section
will ask questions about the pet you want and their role in your
family.
Why do you want a dog in
general?
Why do you want to adopt a
rescued dog?
What are you looking for in a
dog? Please include desired age, sex, size, coat type,
personality and other characteristics that define your desired
pet.
Have you researched about different breeds to
learn about
their specific characteristics, temperament and needs?
Yes
No
If yes, please briefly describe
the research you have performed:
Have you had dogs and/or other pets
previously?
Yes
No
If yes, please list when, breed
of dog and what happened to the dog?
The questions below
address the amount of time you have to spend with a dog,
and what you would be doing with the dog during your time
together.
How many hours will the dog be alone during a
typical day?
If the dog would be alone for 8 hours or more
each day,
do you plan to hire a mid-day dog walker?
Yes
No
Where will the dog be when you are not home
during the day?
Loose in the house
Confined to a room of the house
Crated
Outside
Other
Please describe the place you
indicated the dog will stay when you are not home?
When you are home with your
dog,what kinds of activities would you be most likely to do with
your dog? (i.e. playing indoors, playing outside, lounging,
short/long walks, hiking, jogging, watching TV, napping, etc)
Your response will help us identify a dog with an energy level
that fits your family.
Where will the dog sleep?
Who will feed, exercise and
train the dog?
Does this person or individuals listed above
have prior experience caring for dogs?
Yes
No
If yes, please describe this
experience:
Do you plan to take the dog to professional
obedience classes?
Yes
No
If yes, have you researched dog obedience
classes in your area?
Yes
No
Who is your veterinarian?
Please provide your
veterinarian's contact information
(address and telephone number):
Does anyone in your home have allergies to
dogs?
Yes
No
If yes, how are you managing
your allergies?
How do you feel about crating a dog?
Opposed to Crating
Open to it; never used a crate
Plan to crate when family is not home
If you plan to crate the dog,
please briefly describe how you will accomplish this and where
the crate will be located and the size you will be using:
Do you have experience house-training dogs?
Yes
No
How would you go about
house-training a dog?
How much time do you think it will take the
dog
to adjust to its new environment and family?
What kind of issues would require you to give
up a dog?
(select all that apply)
Health Issues
Excessive Energy Level
Aggression
Shedding
House-training Issues
Barking
Behavioral Issues
Your Own Housing Problems
Others
Please explain your responses
above and why they would cause you to give up a dog?
Have you ever given up a dog?
Yes
No
If yes, please explain why?
Have you ever had a dog stolen from you, or
had a dog run away to never be recovered?
Yes
No
If yes, please explain why?
How much do you think the annual cost of dog
ownership will be?
Who will care for the dog in
your absence, such as emergencies and vacations?
Agreement to our Terms,
Conditions and Recommendations
I certify that my entire household is
supportive of this adoption.
Yes
No
I will teach all household members the
importance of never taking the dog out without a lead, and the
importance of making sure all gates and doors are secure.
Yes
No
I certify that I am at least 25 years of age.
Yes
No
Tara's House considers all of our dogs to NOT
be housetrained, but some arrive housetrained (although you can
expect accidents) and others cannot be categorized until they
are in their forever home environment several weeks. Even
if the dog is housebroken in their foster home, they may not be
housebroken in a new home.
Are you will to accept accidents in your home and work
with your adopted pet to finalize housebreaking?
Yes
No
I will take my adopted Tara's House dog to a
training class and/or crate-train them if recommended by Tara's
House?
Yes
No
I certify that I will adhere to all the terms
and conditions set forth in the Tara's House
Adoption Contract and requirements set for in the online
Adoption Center
should my application result in an adoption.
Yes
No
I agree to allow a representative to Tara's
House to contact me by phone, email or other means to evaluate
my application and take me through the adoption process.
Yes
No
I agree to let a Tara's House representative
to visit my home by appointment to conduct and home visit prior
to adoption and any necessary follow-up visits post adoption?
Yes
No
Our dogs are in foster homes throughout the
greater Washington DC Metro Area. Please note only
applicants who have been through our entire adoption process and
receive approval from us can meet our pets. This process
may take two weeks.
Would you be willing to travel to a particular foster home
to meet the dog you are approved to adopt?
Yes
No
How many miles are you willing to travel to
meet with your approved dog(s)?
Have you applied to any other rescue groups?
Yes
No
If yes, please list the other
groups you have applied with:
How did you find our
organization?
Please include here any
additional information you would like us to consider while
evaluating your application for your desired dog or dogs?