Date of birth (MM/DD/YY):*
Applicant's Place of Employment:*
Spouse or Domestic Partner's Place of Employment:
Type of Pet Requested:
Gender of Pet Requested:
If you are interested in a specific animal, please select the name from the list.
Choose an animal:
What qualities of this pet are you attracted to?
Are you currently expecting a child?
Are you contemplating/planning children in the next 10 years?
Are you willing to take responsibility for your pet for the next 10 years or more?
How long have you lived in your current residence?
Average number of days applicant is out of town per month (business or pleasure):
More than 2 weeks
Do you live in a:
If less than 2 years, what was your previous address?
If you rent, have you discussed having a pet with your Landlord?
Landlord's Name and Phone Number:
List all residents of the household, including age and relationship to applicant:
Does anyone in your family suffer from allergies?
If there are pet allergies in the home, how will they be controlled with a new pet?
If you have children, what has been their exposure to pets?
Is anyone home during the day?
How many continuous hours per day will the animal be left alone?
Where will the animal be during that time? (ex: kennel, single room, whole house, yard, fenced yard...)
Who will be responsible for the pet?
Have all other residents of the home agreed to caring for and loving this pet?
Indicate reasons why you want to adopt:
Please explain the type of pet you are looking for (energy level, size, gender, temperament, etc):
Please explain the research you have done before applying for this animal:
What behavioral or training issues are you able to work with?*
What circumstances would cause you to return an animal to us in the future?*
When outside, how do you plan to keep your pet? Check all that apply:
Where will the pet be kept during the day?*
Where will the pet be kept at night?*
How will you exercise your pet?
How much do you think it will cost to take care of this animal each year (food, vet bills, license)?
How will your pet be cared for during the times when the responsible parties are out of town (business,
If you move what will you do with your pet?
Have you ever owned a pet? If yes, please indicate the type:
Have you ever housetrained a pet? If yes, please indicate the type:
Have you/someone in your family ever dropped off an animal or released an animal to an animal shelter
or humane organization?*
If so, please explain the situation, and the steps taken that led to the decision to surrender:
Please tell us a little about yourself and why you feel you could provide a good home for a rescued pet:*
The following questions MUST be answered if you are applying to adopt a dog.
Have you ever crate trained a dog?
Have you ever participated in an obedience training class?
If issues arise, or if required as part of the adoption, would you be willing to take your dog to an obedience class or work with a trainer?
Do you have a fenced yard:
If yes, please indicate the fencing materials (invisible, privacy, split rail, etc) and height of fence.
If no fence, how will you keep your dog in the yard?
Who will supervise all outdoor activities?
The following questions MUST be answered if you are applying to adopt a cat.
Do you plan to de-claw your cat? Why or Why Not?
Have other cats in the household been tested for FIV/FeLV?
If you have other pets, what is their experience with cats?
The following questions concern any pets that you may have currently, or have had in the past.
Please list the breed, name, and age of all other pets in the home:
Are your current pets spayed or neutered?
If no, why not?
Are your current pets up-to-date on their vaccinations?
Do you currently have a Veterinarian? *
Please list the name and number of the Veterinarian where your pet's records are kept:
If no, what are your plans for finding a veterinarian for your new pet?
Please tell us about the animals you have owned in the past who are no longer with you, and what happened to them:
The following questions MUST be answered if either you or your significant other is a member of the military.
How many members of your family are active military?
How long have you been stationed here?
Did you have any animals at your last duty station?
If yes, where is that animal now?
What would you do with an animal if you are transferred to another duty station here, or abroad?
Please provide names and phone numbers of three references (ensure at least two are not family.) Good references include friends who know your pet history, neighbors who have seen you with your current or past pets, people whose pets you have watched, friends that have seen you interact with their pet, etc.:
1) Reference Name*
Please provide this reference's phone numbers -- at least a home/work or a home/cell*
Please list this reference's relationship to you:*
2) Reference Name:*
3) Reference Name:*
Please list the reference's relationship to you:*
Have you applied to any other rescue groups?*
What was the outcome of your application with the other rescue? Please provide contact information
How did you hear about the King George Animal Rescue League?
Have you ever been convicted of animal cruelty, neglect, or abandonment?*
Before submitting this application, you must read and agree to the following:
I ACKNOWLEDGE THAT ALL THE INFORMATION ON THIS FORM IS TRUE AND CORRECT.
I ALSO AUTHORIZE THE KING GEORGE ANIMAL RESCUE LEAGUE TO INVESTIGATE ALL STATEMENTS CONTAINED IN THIS APPLICATION THROUGH REFERENCE CHECKS, CRIMINAL BACKGROUND CHECKS, PUBLIC RECORD RESEARCH, AND INTERNET RESEARCH.
I UNDERSTAND THAT ANY MISREPRESENTATION OF FACT MAY RESULT IN THE DENIAL OF MY APPLICATION TO ADOPT FROM KGARL, OR IN THE REMOVAL OF THE PET FROM MY HOME BY THE KING GEORGE ANIMAL RESCUE LEAGUE.
I CERTIFY THAT I/WE HAVE NEVER BEEN CONVICTED OF ANIMAL CRUELTY,NEGLECT, OR ABANDONMENT.
I, THE UNDERSIGNED, AFFIRM THAT THE INFORMATION CONTAINED IN THIS APPLICATION AND IN ANY ATTACHMENTS TO THIS DOCUMENT ARE BOTH CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
By signing or typing your full name, you are acknowledging your agreement with the above statements. *
King George Animal Rescue LeaguePO Box 1003, Dahlgren, VA firstname.lastname@example.org ~ facebook.com/kgarl