Corgi Rescue Services Dog Adoption or Volunteer Form

Corgi Rescue Services -- Forever Homes for Corgis --

~ Application To Adopt A Dog ~

Please complete the ENTIRE form. We will NOT process applications that have not been completely filled-out.

~ PERSONAL INFORMATION ~
Your Full Name:
Please List the Names of All Persons in Your Home, Their Relationship to You, & Their Age.
Your Full Street Address, City, State, and Zip Code:
Your Telephone Numbers Including Area Code --> Home:
--> Work:
--> Cell:
Your Email Address:
A Vet Reference is REQUIRED To Process Your Application! Please Provide Your Vet's Name, Clinic/Business Name, City, and Address. Please Advise Your Vet That You Have Applied To Adopt A Rescue Dog And That We Will Be Calling Them For A Reference. We Will Schedule A Home Visit After Receiving A Recommendation From Your Vet. If You Do NOT Have a Vet Because You Have No Pets, You Must Obtain Contact Info For the Vet You Plan to Use For Your New Pet.
Your Vet's Phone Number Including Area Code:
1st of Three Non-Family Character References - Full Name:
1st of Three Non-Family Character References - Street Address:
1st of Three Non-Family Character References - Phone No.:
2nd of Three Non-Family Character References - Full Name:
2nd of Three Non-Family Character References - Street Address:
2nd of Three Non-Family Character References - Phone No.:
3rd of Three Non-Family Character References - Full Name:
3rd of Three Non-Family Character References - Street Address:
3rd of Three Non-Family Character References - Phone No.:
Is everyone in the family agreeable to getting a new pet?
How Would You Exercise Your Pet?
Your Occupation, Employer, and Length of Time Employed There:
Your Spouse's Occupation, Employer, and Length of Time Employed There:
If You Adopt A Dog From Us and We Find That You Are Not Meeting Our Standard In Caring For Him or Her, You Will Be Required To Return The Dog To Us At Your Expense Immediately. Do You Agree To This (yes or no)?
You agree that if you are no longer able to care for the dog that Corgi Rescue will be notified and the dog will be returned to the Rescue(yes or no)?
You Also Agree That if Issues Arise After You Have Taken the Dog into Your Home, that You Will Work with Corgi Rescue for at Least One Month to resolve These Issues Prior to Returning the Dog: (yes or no)?
Excluding Death or Disability, What Other Circumstances Would Cause You To Dispose of A Dog That You Adopted From Us:
Are You Aware There Is An Adoption Donation For Each Dog In Our Rescue? Do You Know What It Is For? Would You Like Us To Explain:
~ ABOUT YOUR HOME AND YARD ~
What Type of Home Do You Live In:	House Apt Town-House Condo Mobile-Home
Do You Own or Rent Your Home (Please Type In: own or rent):
If You Rent, Does Your Written Lease Allow Pets (Please Type In: yes or no):
Landlord Name and Phone Number:
If You Have a Yard, Is it Fenced? Is It Directly Accessible From Your Home? Please Describe Fence and Yard, If You Have One:
If You Don't Have a Fenced Yard, Please Describe How the Dog Is To Be Exercised:
~ OTHER ANIMALS ~
Have You Owned Any Dogs Or Cats That Are No Longer With You? How Many? Please explain what happened to each one:	Yes No
Do You Currently Own a Dog(s):	Yes No Please List How Many, Breeds, and Ages.
Do You Currently Own a Cat(s) or Other Pets:	Yes No How Many? Type of Pet If Not Cat
Were These Adopted From A Dog Pound/Shelter Or Taken In as Stray:
In Which Dog(s) of Ours Are You Interested? ID Number? If No Particular Dog, Please Note Your Preferences Below, So We Can Let You Know When Such a Dog Becomes Available.
You Desire a Pure-bred dog, Mixed breed, or No Preference:	Pure Mixed No Preference
You Desire a Male, Female, or Either:	Female Male Either Sex
What age range would you like your dog to be:
Please Name Three Traits You Are Looking for in Your New Companion:
Would You Adopt A dog With Special Needs? If You Would, Please Check Which Special Need(s) You Would Accept:	Blind Deaf Diabetic Epileptic Arthritis Allergies Daily Meds Incontinent Cannot Climb Stairs Back Problems
What Type of Personality Are You Looking For In A Dog:
How Long Are You Willing To Wait For A Rescued Dog:
Please Allow One Week To Process Your Application. If You Do Not Hear From Us By Then, Please Contact Us Again. Please click SUBMIT now. It will email your application to us, then return you to our home page. --- (If We Approve Your Application, We Will Require You To Sign An Adoption Contract.)