First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

I acknowledge that I have read and understand the policies and fees associated with adopting a dog found on the adoption information page. Our fees are based on the costs associated with saving dogs from high kill shelters. These fees cover the costs to pull a dog from the shelter, provide vetting, Spay or Neuter, transport to Vermont and one month of vetting and food. VT Adoption Fees Puppies - $400 Adults - $375 Seniors - $275*
Choose one: Yes

I acknowledge that All Breed Rescue is not liable for any injures on their property.*
Choose one: Yes No

Are you over 21 years of age? If you are not at least 21 you cannot apply to adopt a dog.

What is your age and the age of any co-applicants?*

Which location are you interested in adopting from?

What is your occupation?

Who is your employer?*

Years worked there*

Co-Applicant First Name

Co-Applicant Last Name

Relation to Applicant

Co-Applicant Occupation

Co-Applicant Employer

Co-Applicant Years Employed there

Type of Dwelling*
Choose one: House Condo Apartment Mobile Home

Years at Residence*

Do you own or rent your home?*
Choose one: Own Rent Live With Family

Does your Condo, Mobile Home Park, or Homeowners Association have any restrictions on pets?*
Choose one: Yes No

If you rent your home, we will need to confirm with your landlord that you are permitted to have a dog. Please discuss with your landlord if a dog is allowed on your property and any restrictions or pet rent you may have. 

Landlord Name (if renting)

Landlord Phone Number

I understand that my homeowners insurance policy may include restrictions on certain dog breeds, and that is my responsibility to read and understand my policy before deciding whether to adopt a dog.

Do you have a yard?
Choose one: Yes No

Is the yard fenced in?
Choose one: Yes No

How tall is the fence?

Family Size*

Number of Adults*

To avoid dogs being returned due to family disagreement about dog adoption, all adults in the household must be in agreement and willing to have an ABR volunteer contact them. Please list the name and phone number of all other adults living in the household and their relation to you (excluding applicant and co-applicant):

If there are children who live in or frequently visit the home, what are their ages? *If you have young children at home, we would love to speak with you in greater detail about your plans to integrate a dog into your family life.**

Does everyone want a dog?*
Choose one: Yes No

Family Activity Level*
Choose one: 1 - Not Active at All 2 - 3 - 4 - 5 - 6 - Moderately Active 7 - 8 - 9 - 10 - Never Stop Moving

What previous experience do you have owning, living with, or working with animals?*

Do you currently have pets? or any pets in the home?*
Choose one: Yes No

What type of pet(s) do you have? Please provide the species and name of each pet in your home.

If you have pets, are they spayed/neutered?*
Choose one: Yes No N/A

If you have pets, are they up-to-date on all required vaccines?*
Choose one: Yes No N/A

Name of your current Veterinarian*

Current Veterinarian phone. If you don't have pets, you can leave this blank.

I acknowledge that it is my responsibility to have my veterinaries office email my pets vaccination records to All Breed Rescue at allbreedvt@allbreedrescuevt.com.*

Have you ever given away a pet? If so, please provide a short explanation.*

Please provide 2 personal references, only one of which may be a family member. Please include their contact information and relation for each reference. *

How much do you think it will cost yearly to care for a dog?

Why do you want a dog?*

Have you ever crate-trained a dog?
Choose one: Yes No

Is someone home during the day?
Choose one: Yes No

How many hours will the dog be alone during the day?*

Where will the dog be kept when alone (i.e. crate, yard, run of house)?

Where will the dog sleep at night?*

How will the dog be exercised each day?*

Realizing that no dogs are perfect all of the time, what is your level of commitment to work with an adopted All Breed Rescue dog brought into your family if problems (medical, behavioral, etc.) arise?*

Are you aware that changing a dogs environment may cause initial stress and cause the dog to have accidents?

What do you consider a reasonable amount of time to allow your dog to adjust to its new home?*

If a behavior problem arises with your dog, what steps will you take to work on it?*

Do you plan to enroll your dog in obedience classes?

Do you plan to take your dog to doggy daycare, a dog park or other dog friendly social activities?

Who will care for your dog when you go on vacation or travel for work?*

If you move, what will you do with your dog?*

In the event of a life changing event (divorce, break-up, death of a family member etc.) what will you do with your All Breed Rescue adopted dog?*

What circumstances would cause you to return a dog to us?*

Gender
Choose one: Any Male Female

Age
Choose one: Any Puppy 1-2 years 2-5 years 5-8 years 8+ years

Size
Choose one: Any Tiny Small Medium Large Giant

Is there a specific dog you are interested in?
Choose an animal: Caneel Copper Jabreezi Matrix Sosa Star

Is there another specific dog you are interested in?
Choose an animal: Caneel Copper Jabreezi Matrix Sosa Star

Is there another specific dog you are interested in?
Choose an animal: Caneel Copper Jabreezi Matrix Sosa Star

How did you hear about All Breed Rescue?*