Name of the dog you're interested in
What is your primary reason for wanting a dog?
If you were referred by an APR adopter/volunteer or friend, please share who it is here:
Please tell us your age. Note, you must be 25 years of age to apply.
Please list names and ages of everyone in your household:
If you have children, please describe their previous experience with dogs. If you are expecting, please also note that here.
Occupation and place of work:
Please provide landlord's telephone number.
If you share your yard with anyone else please list them here?
What type of fencing do you have?
How high is your fence at the highest point?
How high is your fence at the lowest point
If yes, how high is your gate?
Are there locks on the gate? (If not, would you be willing to put padlocks on your gate?)
Who has access to your yard?
If indoor/outdoor, please estimate the percentage of time the dog will be indoors and outdoors.
Do you have a dog door? (If not, would you be willing to install one?)
Which rooms in the house (if any) are off-limits to the dog?
Is the dog allowed on the furniture?
When you are not home, where will your dog be? (Please be specific).
Is anyone home during the day?
Where will your dog sleep? (Please be specific.)
Do you have a dog now? If yes, please list breed and age.
Do you have any other pets? If yes, please list types of pets.
Are your pets spayed or neutered? (If no, please explain.)
Have you ever had a dog before? If yes, for how long?
If you no longer have the dog, what happened to him/her?
Have you ever lost a dog? If yes, please explain.
Please describe your previous level of dog experience:
What would happen to your pets if you moved?
What will you do if you can no longer keep your pet?
In the past, have you ever been forced to give up your pet? If yes, please explain the reasons for giving up your pet.
If you have given up a pet in the past, what did you do?
If other, please explain.
If yes, please list your vet's name and telephone number. If no, would you like a recommendation?
Please list your annual budget for vet care (if any):
If you selected "no" please explain why you would not get pet insurance.
If dog were to do one of the above behavior issues (nipping, biting, barking, digging)...will you be willing to consult a trainer (to try to rectify the situation) before giving the dog up? (If no, please explain)
PLEASE READ AND AGREE TO THE STATEMENTS BELOW
Thank you for choosing adoption! We will review your application and get back to you as soon as possible. Please note that A Purposeful Rescue is 100% volunteer run, so please be patient as it may take up to 48 hours to receive a reply.
If you don’t receive a response within 48 hours, please check your spam folder!