By completing this application, it is understood between you (applicant) and Redemption Rescues (RR) that all information set forth will be confirmed by an RR representative. It is further understood that completing this application does not automatically grant adoption approval. 

Contact Information
Name *
Name
Date of Birth
Date of Birth
Home Address
Home Address
Day Phone
Day Phone
Evening Phone
Evening Phone
Family & Housing
Please describe your household
Have you or anyone in your family ever been charged or convicted of animal abuse or neglect?
If you rent, please give the rules governing pets AND the landlord’s name and number: By providing this information you are allowing RR to contact your landlord. please inform them of this call so they will speak with us
How would you describe your level of experience with dogs? Please check all that apply
Other Pets
If not, why?
If not, why?
If not, why?
Veterinarian
Do you have a regular veterinarian
Clinic Address
Clinic Address
Clinic Phone
Clinic Phone
(Providing RR with this information you are allowing RR to call your vet. Please call your vet and ask them to authorize the release of information to RR.)
About the Dog You Wish to Adopt
Desired sex
Willing to adopt
Allow time for adjustment of a few weeks. It is important that you commit and not give up on dog during this time. Can you invest the time and effort to allow this dog to adjust to its new home?
Do you agree to provide regular health care by a Licensed Veterinarian
Do you agree to keep the dog as an indoor dog
Do you agree to contact RR if you can no longer keep this dog
Are you be willing to let a representative of RR visit your home by appointment
Would you be interested in fostering?
Personal References

All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian. If any information given is proved to be false, adoption can and will be revoked.