General Intake - Adoption Application

Your Personal Information

Full Name

Address

Phone Number

Best number to reach you at

Email

Valid Email Address

Instagram Handle

If you don't have Instagram, please write N/A

Age

dd/mm/yy

Are you employed?

Occupation

write N/A if none

Emergency Contact Name

Emergency Contact Number

Relationship

Adoption Questionnaire

How long have you been looking to adopt a dog?

Have you applied for another dog at any other rescue organization in the past month?

If yes, is your application still pending? Please describe below:

If no, please write N/A

What size dog are you looking for?

please pick as many answers as relevant

What age dog are you looking for?

Please pick as many answers as relevant

Why do you want to adopt a dog?

A dog can live for over 10 years and requires a major commitment of time and resources. Why do you feel you can make that kind of commitment at this time?

How many people, including you, live in your home?

Details of people living in your home (Full Name, Age, Relationship)

Do you and/or people in your home have previous experience with dogs?

If yes, please explain

if no, write n/a

Does everyone in your home agree to adopting?

Do you have a valid drivers licence to drive a car?

Do you own or have access to a car?

Where do you live?

Do you rent or own?

If other, please describe below

If you rent, does your lease allow dogs to be kept inside as companion animals?

Name of landlord

write N/A if you own

Phone number of landord

We don't always contact the landlord, but we do need this information on file to make sure dogs are allowed in your lease, if there is ever an eviction problem. Write N/A if you own.

If you live in a house, do you have access to a backyard?

If yes, is it fully fenced?

Does your home have stairs?

Are there any children under 8 in your home?

If yes, how old?

Write N/A if none

Do you agree to home visits to ensure the safety of the pet?

Would you consider your home environment to be safe for the animal?

If no, please explain

Do you or any members of your household have allergies to animals?

If yes, please explain:

Have you or members of your home been convicted of a felony or for animal cruelty

If yes, please explain

How many hours a day do you expect the dog to be left alone in a normal routine?

Please explain the work hours for everyone in your household and if the work is done from home or away

Do you plan on crating the dog while you are away for the day?

We recommend dogs not be left alone for more than 8 hours without having a chance to relieve themselves. If you expect to be away for longer in a day, how will you ensure the dog gets to answer the call of nature in a timely manner?

Where will the dog sleep at night?

When you go on vacation or if you travel somewhere for work, where will the dog stay?

Do you have any trips planned for the near future? If yes, please explain:

Do you have any home renovations planned for the near future? If yes, please explain:

Who from the family will be responsible for primarily feeding the dog?

Who from the family will be responsible for primarily exercising the dog?

Who from the family will be responsible for primarily training the dog?

If you move, will you take your dog with you?

Your new dog may need time to decompress after their arrival. Decompression period may involve challenges like low confidence levels, chewing, barking, leash reactivity, etc. Do you agree to helping your new dog through this.

select one

Do you have experience training a dog for challenges like leash reactivity, separation anxiety, etc? Please explain

Would you be willing to work on any behavioural challenge that may show up at a later point?

What challenges in your new dog are you unable to accommodate?

When you get your new dog, what type of activities do you plan to do with him/her? Please give some examples.

How much daily exercise can you provide?

In your own words what makes a responsible pawrent?

Under what circumstances would you return a dog?

Do you currently have pets in your home?

Have you ever adopted a dog from a shelter or rescue before?

Did you ever have a dog who had a litter of puppies? If yes, please explain the situation. If no, write N/A.

Please give any details you can of current pets (type, number, age, breed, gender). Otherwise write N/A

If you have a dog/cat, are they spayed/neutered?

Who is/was your veterinarian? Please list their contact information below. If you have not had any vets, write N/A

Are the vaccinations for your pets up-to-date?

How will you introduce your new dog to your current existing animal? Please explain. Otherwise write N/A.

Past pets, if any?

Please give any details you can of past pets (age, breed, how they passed away). Otherwise write N/A

Vetting

How often do you plan on taking the dog to the vet?

If a vet recommended a surgery that could guarantee a better quality of life for your dog, but the surgery was too expensive for you, would you consider putting the dog to sleep? If yes or not sure, please explain your financial threshold and what factors would go into making this decision.

In what other circumstances would you consider putting the dog to sleep? Please provide some scenarios.

If putting the dog to sleep has to be considered at a young age, you agree to notify Animal Care Zone and you are willing to see if ACZ has any other recommendations/suggestions

If your dog becomes sick or injured will you be willing to take care of all the expenses that arise from this?

Dental care in dogs is sometimes neglected. However, it is very important and if not taken care of can cause serious diseases. Do you agree to provide your dog with dental care, if recommended by a vet?

How much do you expect to spend a year to feed, train, vaccinate, dog-sit, licence and provide medical care for the dog?

How have you planned to pay for vetting expenses?

How have you planned to pay for training expenses?

Did anyone from ACZ (board member, volunteer, foster, supporter, donor, etc) recommend you? Who should we thank?

Do you have any physical or psychological ailments that might prevent you from performing your duties as a responsible pawrent, to the best of your ability?

select one

If yes, please explain. Otherwise write N/A

Anything else we missed, that you want to share with us?

Please provide 3 references below who we can contact. An immediate family member, a significant other or a live-in partner cannot be one of your reference.

References

Name of Reference #1

Full Name

Phone Number of Reference #1

Email of Reference #1

Valid Email Address

Relationship between you and Reference #1

Name of Reference #2

Full Name

Phone Number of Reference #2

Email of Reference #2

Valid Email Address

Relationship between you and Reference #2

Name of Reference #3

Full Name

Phone Number of Reference #3

Email of Reference #3

Valid Email Address

Relationship between you and Reference #3

Adoption Requirement

Please read the below. By clicking "agree", you understand and agree with the following:

• All members of the household are in agreement about adopting a dog - all adults will be present for the interview and meet and greet process.

• You have budgeted for good quality pet food and supplies, emergency medical issues, training, boarding costs, and adoption fees.

• You have set aside time during the transition period to bond with your new dog (long walks, various activities to build trust, a flexible schedule if required).

• You have the appropriate amount of time to spend with the dog (minimum 2 structured walks per day, regular training time, etc).

• Alternate homes/pet sitters/dog walkers should the dog require or if you are away on vacation.

• Relevant preparation for dogs with special needs.

• Basic knowledge of dog training and care (research put into the time required to bring a new dog into the home and prepared for adjustment period including but not limited to separation anxiety, accidents in the home, proper introductions to pets and people living in the home, nervousness in a new environment, crate training, etc). Finances for a professional dog trainer is needed.

• Willing and open to training ideas from ACZ

• If adopting a puppy - flexible schedule to ensure frequent potty breaks and all required puppy training.

• Willingness to reach out for help/advice for any concerns that may arise with your new dog.

• Willing to send pictures and updates to ACZ from time to time

  • I understand that if I can no longer take care of the dog, I must notify ACZ first, ASAP. I understand that ACZ will do it's best to rehome the dog. I agree to give time to ACZ for this process, and will not sell the dog to a third party, or put the dog in an animal shelter.

Return

If I can no longer take care of my dog, I agree to give the dog back ACZ in order for the dog to be rehomed. I understand that if I return my dog within the first 2 weeks of adoption, I am eligible to get 75% of my adoption fee back.

If I return the dog after 2 weeks, I understand that I forfeit the full adoption fee that I paid. Additionally, If I return the dog after 3 weeks, I understand that a surrender fee/surrender donation may apply.

Adoption Fee

I understand that Animal Care Zone is a not-for-profit organization dedicated to animal care in India and Canada. The adoption fee helps us cover the cost we incurred in the rescue, transportation and vet care of the dog. It allows us to continue on with our work and rescue more dogs. The adoption fee is as follows: puppies up to 1 year old $700, dogs 1 year and older $600, seniors $500, and bonded pair $500. (If a dog is adopted without being spayed/neutered, an additional $150 deposit is added to the adoption fee and is refundable upon completion of spay/neuter). *


In submitting this application, I understand and agree to the following:


I understand that any misrepresentation of the above information authorizes Animal Care Zone to deny application, and/or reclaim the dog that is in my home. I will not hold Animal Care Zone responsible, nor seek any compensation for damages, medical fees or other liabilities incurred by the pet I adopt. 


Animal Care Zone will complete medical checks of the animal beforehand and assist with any behavioural problems beforehand, to the best of the team’s ability. However, I understand that Animal Care Zone cannot guarantee any dogs against parasites, diseases or destructive behaviour. I understand that there is a still a risk that I may be scratched, bitten, or may come into contact with a diseased animal. I agree to release and hold harmless the Animal Care Zone and its employees from any and all liability for any damage or injury, whether arising from this contract or a breach thereof or from any act of negligence or gross negligence by the Animal Care Zone, or its volunteers.

Applicant Name

Signature

2025-02-05