PROUD (Pet Rescue of Unwanted Dogs) Adoption Application & Agreement *Loving Homes for Loving Dogs* IT IS IMPORTANT THAT YOU FILL OUT THE APPLICATION COMPLETELY. IF YOU FEEL THAT A QUESTION IS NOT APPLICABLE TO YOU, PLEASE PUT "NOT APPLICABLE." PART I: 1.  Name /Home Address & Phone Number: 2.  Work Address & Phone Number: 3.  E-Mail Address: 4.  If applicable, Spouse's Work Address & Phone Number: 5.  Name of Dog(s) You Would Like To Adopt: ___________________________ 6.  How did you hear about this particular dog(s)? ________Petfinder.org _______Pets911_______Other (please explain ;-).

PART TWO: 1.  Do you rent or own your home? _______ Own _________ Rent . 2.  Do you have the landlord’s permission to keep a dog(s)? _____ Yes. ______ No _____ Not Sure. 3.  Landlord’s Name & Phone Number:  ____________________. 4.  Do you live in  a house or apartment? ________ House ________ Apartment _______Trailer _______ If Other (please describe) _____________________. 5.  How long have you lived at this address? ___________________. 6.  Do you have a fenced yard? ______ Yes ________ No. 7.  How many feet  is your fence at its highest point and at its lowest point? ________________________.

PART THREE 1.  Number of adults in household? ________. 2.  Number of children in household and their ages? ________. 3.  If you do not have children in your home, will the dog(s) have contact with children of friends, relatives, etc.. _________. 4.  Do you have livestock or farm animals? __________. 5.  Do you own other dogs? ___________. If so, how many? ______________. 6.  Do you own a cat or cats? ____________. If so, how many? ____________. 7.  Which of your pets are spayed or neutered? _____________. 8.  If some or all of your pets are NOT spayed or neutered, why not? _________________________. 9.  Give breed, sex and age of each pet in your care ____________________________________________________________. 10.  Do you own any other type of animals? _____________. 11.  If so, what kinds of other animals ? __________________________. 12.  How long did you have your last dog? _________________. If you owned your last dog for less than a dog’s normal life span, 10-15 years, what happened? _____________. 13.  Name & Phone Number of Your Regular Veterinarian __________________________________. 14.  Do you grant a representative of PROUD (Pet Rescue of Unwanted Pets) permission to contact your veterinarian as a means of reference ? ____ Yes ______ No.

PART FOUR 1.  Have you owned a _____________ or similar breed type before? ____ Yes. _____ No. 2.   What are your plans for this dog? (Please Check All That Apply): ________Member of the Family. _____ Pet. ________ Best Friend.  ______Guard Dog. _______Herding Dog. _______ Obedience/Agility. _______ Therapy Dog. ____ Hunting. ______Other. 3.**If you chose “Other,” please describe __________________________. 4.  Do you agree to consistently provide suitable dog food and fresh water for the dog(s)? _______ Yes _______ No. 5.  What do you believe to be the most effective training methods to train dogs? (Please Please Check All That Apply): _________ Food Treats. __________ Praise. ________ Physical Punishment, On Certain Occasions.  _________ Obedience School. __________ Positive Reinforcement for the Behavior You WANT. 6.  If this dog(s)  is not house trained, how will you train him or her to not go to the bathroom in the house? (Please Check All That Apply) ________ Crate Training __________ Carefully Watching and Anticipating his/her Need to Go to The Bathroom and sending him/her Outside and Praising When he/she goes to the bathroom. __________ Rubbing his/her nose in its “mess”  and then sending him/her promptly outside. __________ I have no idea, but I’d like some information on the subject. 7.  How many hours a day, on average, will this dog(s) spend alone? _______________. 8.  Where will the dog(s) spend the night? ________________. 9.  Will this dog(s) be primarily an outside or inside dog(s)? _________________. 10.  When you go out of town, who will take care of this dog(s)? _______________________. 11.  If you by chance move in the next 10-15 years, what will you do with the dog(s)? ___________ Give the dog(s) to a friend. __________ Take the dog(s) With us no matter what! __________ Give the dog(s) back to PROUD. __________Take the dog(s) to the nearest animal shelter to find a new home. 14.  Can you imagine any circumstance that would cause you to feel that this dog(s) would no longer be welcome at your home? _______ Yes. Please explain______________________________. _______ No. 13.  At PROUD, we are looking for great homes for all of the pets in our care.  In what way would you provide a particularly good home for this dog(s)? Please explain.

PART FIVE: 1.  Do you agree to license this dog as required by city law, AND provide it with regular (at least once per year for a routine checkup) health care through a licensed veterinarian? ______ Yes. ________ No. 2.  Do you agree to provide a properly fitted collar and  ID tag with your current address and phone number ? _________Yes. ________ No. 3.  Do you understand that it is MANDATORY that you contact PROUD FIRST to make arrangements for us to pick up the dog, at ANY TIME during the natural life span of this dog , if you are no longer able to keep him or her? _______ Yes. _________ No.

PART SIX 1.  Do you understand that if the above requirements are NOT met, that PROUD (Pet Rescue of Unwanted Dogs) has the RIGHT to RECLAIM the dog(s) ? _______ Yes ________ No. 2.  Would you be willing to allow a representative from PROUD to visit your home by appointment? ______ Yes ______ No. 3.  If not, please explain _________________________. 4.  Do you agree to pay the adoption fee for each dog(s), (name of dog(s)_____________________ you might be adopting?) ________ YES _______NO * YOU MAY RECEIVE A FULL REFUND ON THE ADOPTION FEE FOR 30 DAYS AFTER YOU ADOPT THE DOG(S) IF YOU RETURN THE DOG(S). IT IS REQUIRED THAT YOU RETURN THE DOG(S) TO PROUD IF YOU ARE NO LONGER ABLE TO CARE FOR THE ANIMAL FOR ANY REASON, AT ANY TIME IN THE DOG OR DOGS' NATURAL LIFE SPAN. 5.  Do you agree that upon adoption of: _______________ . that PROUD Sanctuary CANNOT be held responsible for the above mentioned dog(s) temperament or health? _____ Yes. ______ No. 6.  By signing below, I declare all of the above information to be true and complete to the best of my knowledge: Printed Full Name: ____________________________. Signature: _____________________________.    Date:  ________________. (Hand-written signature(s)  required prior to adoption) Spouse’s Printed Full Name: _________________________. Spouse’s Signature: ____________________________. Date: _____________. Printed Name of Qualified Representative of  PROUD (Pet Rescue of Unwanted Dogs) : ______________________________. Signature of Qualified Representative of PROUD: _______________________________.    Date