Southeast
Texas Labrador Retriever Rescue (STLRR)
Adoption
Application
Name
_______________________________________________ Application date ______________________
Address
____________________________________________________________________________________
City
______________________________________ Prov: _____________ Postal Code:
___________________
Home phone:
_______________________________ Work phone:
____________________________________
Best time to call each/either
number: ___________________________________________________________
Email Address: ______________________________________ May we contact you via email? ___________
PLEASE NOTE: You must
complete the entire application. Incomplete applications will be
returned for completion, thus slowing the application process.
Please list and describe
your current dog(s) first, and then any other dog where you were the primary
caretaker:
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Spayed/Neutered? |
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Dog
owned now, or deceased? |
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Has your current dog ever
lived with another dog? Was it a male
or female? Spayed or neutered? If so, how well did they get along?
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How long has your current
dog been an “only dog”? ___________________
Are your current dogs on
heartworm preventative medication?:
Yes No If so, which one do they take, and how
often?:
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Why do you especially want
to own a Labrador Retriever, vs. other breeds?:
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Have you ever had to give
up a dog/give it away/euthanize a dog for behavioral issues?
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Please explain the
circumstances:
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Do you have any other animals?
Please list what you have, if they are spayed or neutered and note whether
they’ve ever lived with a large dog before:
(For instance, cats, pet rodents, birds, etc.)
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Is your dwelling a: house
apartment townhouse
other (describe)
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Do
you own or rent ? If you rent, we require written landlord
consent to bring animals onto property. Please provide name, address and phone
of landlord below, and include written
consent w/application:
Do you have a fenced-in
yard or fenced area attached to your house?:
Yes No
If yes, what type of fencing? ______________________
Height: _________________ Length: ____________________
Width: __________________
Is the fencing dug into the ground?: Yes No If so, how deep?: _____________
Is fenced area attached to the house?: Yes
No
If not
attached to the house, how far away is it from the house? :
If you do not have a fenced area attached to your house,
would you be willing to install one or
adopt a more appropriate Senior Labrador Retriever?
How would the fenced area be used?:
Are
you aware of any distractions outside your yard that could plague the dog while
he is out? (such as neighbors dog or cat, loose dogs on street, mischievous
children, neighbors who don’t like Dogs)? Please list these things – we just
want you and STLRR to be aware of them:
Do you have a pool? Yes
No
If
NOTE: If the pool is in-ground and in your fenced
yard/area, you must have a fence around the pool so that the dog cannot fall
in. If the pool is above-ground and in your fenced yard/area, you must have a
gate to prevent the dog from going up the steps/falling in. Refer to your
application packet to the sheet on Fences for policy information.
Please
tell us about all people an adoptive Labrador Retriever would usually come in
contact with, including your spouse, roommates, children, neighborhood
children, grandchildren, friends, relatives, etc.:
Name Age Relationship to you Lives with you?
Visits how often?
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Name Age Relationship to you Lives with you?
Visits how often? |
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Where
will your Rescue Labrador Retriever sleep at night?
_________________________________________
Where
will your Rescue Labrador Retriever stay during the day when you are home?
_________________
Where
will your Rescue Labrador Retriever stay during the day when you are NOT
home?_____________
What is your expectation
regarding a rescue dog's obedience training level?
Completely trained Somewhat trained Untrained okay
When you say "the dog
is obedience trained" - what do you mean?
Please
describe in detail what behaviors in a dog or what training is important to
you, and describe (on the back of this sheet) how you would train the dog to
exhibit these behaviors. If you don't know how you'd train for some behaviors,
please just note that.
Who is your veterinarian (name/address)?: ____________________________________________________Telephone:_______________________
If you do not yet have a veterinarian, who do you plan on using?
Please list the names of
two references. References should have a strong feeling for what you are like
as a dog owner and should NOT be related to you. (Note - please print
this information)
References
1. Name:
__________________________________________________ Phone: ___________________
2. Name:
___________________________________________________ Phone: ___________________
The
basic needs of a healthy Labrador Retriever (feeding, well-dog vet visits,
etc.) can cost approximately $500-800 per year! Any health or behavioral
problems with the dog could increase this amount. You need to anticipate that the dog could need emergency surgery,
or you might want to take the dog to additional training classes, etc. and this cost is something you need to be
ready for.
Does this financial responsibility present a
problem? No Yes
Can you make the full adoption
donation for the dog at the time of adoption? ($___) __________
Under what circumstances
would you find it necessary to get rid of, or re-home your Rescue dog?:
Moving Change in schedule Marriage to somebody who doesn’t like
your dog
Divorce New Baby Current pets don’t like new rescue dog Illness
Other (please specify):
Have you applied anywhere
else within the past year to adopt an animal?
No Yes (where and when?):
Please
describe the perfect dog for you. What characteristics are you looking for? As
you answer this,
please think about your lifestyle - are you active, in and out a lot, are there
lots of people/children around, etc., or are you more sedentary, quiet, with
few visitors? What personality in a dog would best fit your family's needs
and lifestyle? Would your dog go with
you everywhere or stay at home with you a lot? Do you have other pets that need
consideration?
Of all of the
characteristics you listed above for your perfect dog, please note the 2 things
that are most important to you:
1)__________________________________________________________________________________
2)__________________________________________________________________________________
How did you hear about
STLRR? :
My
signature below indicates that I am at least 21 years of age and intend to be
the legal owner and the person responsible for the care and well-being of any
dog I adopt from Southeast Texas Labrador Retriever Rescue (STLRR).
In
signing this application below, I give representatives of STLRR permission to
contact my veterinarian, references, and landlord if that applies, for
information to aid in the evaluation of whether a Rescue Labrador Retriever is
appropriate for me and my current living situation
See also the following page for Terms
of Adoption information and sign your understanding of those terms.
SIGNATURE:____________________________________________
DATE: _________________________
Please return your signed,
completed Adoption Application and Terms of Adoption form (and if applicable,
written landlord consent) to:
Southeast Texas Labrador
Retriever Rescue,
5535 Memorial Dr.
Suite F, Box #554
Houston, Texas 77007
Terms of Adoption
Cost
The
adoption donation for most Labrador
Retrievers is $___,which helps to partially defray the veterinary and
boarding expenses we incurred in rescuing and caring for the dog. The donation
for Senior dogs and Special Needs dogs is
$ . Adult Labrador
Retriever will have been neutered or spayed, given all necessary inoculations
including a Rabies shot, heartworm tested, stool tested for parasites, and given other medical treatment
needed for problems that STLRR is aware of and can treat, before adoption.
Return policy
If,
for any reason, the adoption is not satisfactory for the Labrador Retriever or
for adoptive owner, STLRR requires that the dog MUST BE RETURNED, at adoptive owner’s expense, to STLRR, within 2
weeks of notification. The dog may NOT
be sold or given to a new owner. STLRR reserves the right to take back this dog
if it is ever neglected, improperly cared for, or allowed to become a nuisance
to others.
Releases
The
adoptive owner must sign a legal release before visiting any Rescue dogs, and
sign a legal contract at the time of adoption to protect him/herself, Southeast
Texas Labrador Retriever Rescue and its representatives, and the Labrador
Retriever involved in the visits/adoption process.
Tattoo / Microchip
We
recommend that if this Labrador Retriever is not already tattooed, that Adopter
will microchip the dog with STLRR-designated number within 2 months of
adoption, at Adopter’s expense.
License
If
adopted, this Labrador Retriever must be licensed in accordance with
existing laws in the adoptive owner's
town, and the Rabies vaccination must be kept current, for the dog's life.
Care
The
adoptive owner agrees to provide proper shelter, high quality food as advised
by STLRR, and proper medical care including annual heartworm tests, and agrees
that this dog will not run free without supervision, be chained out, be allowed
around children under 14 years without adult supervision present, be allowed to
ride loose in the back of a truck, or be used for guarding purposes. Failure to
comply with these terms will require that the dog be surrendered immediately
and returned immediately to Southeast Texas Labrador Retriever Rescue, without
refund.
Southeast
Texas Labrador Retriever Rescue recommends that you follow a regular
inoculation program established by your veterinarian.
Your
dog will need an annual veterinary visit with a Rabies booster in accordance
with provincial regulations.
Your
dog must have an annual heartworm
test and your veterinarian will recommend a preventative heartworm program for
year-round prevention.
STLRR
requires that adopter enroll in an obedience training program with your adopted
Rescue dog to increase the bond between you, and to be sure you know how to
teach your dog basic pet obedience exercises and rules.
By
signing this document, I give STLRR the right to check with other rescue
groups, humane societies, or my veterinarian and/or to share information about
my application with said other groups or with my veterinarian.
By
signing this document, I understand and agree that STLRR has the right to
refuse my application if application or home situation is deemed by the STLRR
Board of Directors as not appropriate for a
Rescue
Labrador Retriever.
I
also understand that any misrepresentation of the true facts in this
application or in the adoption agreement will invalidate the adoption agreement
and will give STLRR the right to reclaim the adopted Labrador Retriever without
refund of the adoption fee.
My
signature below indicates that I understand these Terms of Adoption and agree
to abide by them if I
adopt a dog from Southeast Texas Labrador Retriever Rescue.
My
signature also indicates that I am willing to have a person representing
Southeast Texas Labrador Retriever Rescue visit my home (for a Home Visit
interview) by appointment prior to adoption proceedings.
SIGNED
AT __________________________________
SIGNATURE:
______________________________________________
DATE:
__________________________
WITNESS:
_________________________________________________
DATE:
_________________________