Ruffus Rescue Online Application

I am interested in adopting:

Contact Information:
Your Name:   
Home Phone #:   
Work Phone #:   
Cell Phone #:   
Other Information:
Type of Employment:
Date of Birth:  

Please answer all applicable questions by checking the appropriate boxes and providing any additional information which might help us evaluate the suitability of this adoption:
1. What type of pet are you looking for?
2. Did you come to our adoption site intending to adopt a pet today?
3. What is your reason for adopting this pet?
(check all that apply)
4. Are you willing to allow Ruffus Rescue to visit your home and inspect where the dog will be kept?
5. How long have you lived at your current address?
6. How many times have you moved in the last 6 years?
7. My home is:
8. Do you own or rent?
If you rent, does your landlord allow pets?
Is there a pet deposit?  
If yes, how much?
Have you already paid the pet deposit?
Name of landlord or apartment complex:
Landlord/apartment phone number:
9. If you move, will your pet go with you?
10. Would you consider moving somewhere that does not allow pets?
11. Do you foresee any major life changes in the next 15 years?
If yes, please explain:
12. Can you provide a home for this pet for 10 to 15 years?
13. How many adults live in your household?
14. How many children live in your household?
What are the gender and ages of the children?
15. Do all members of your household know you are planning to adopt a dog?
If no, please explain:
16. Does anyone in your household smoke?
17. Is anyone in your household allergic to animals?
18. Does anyone in your household have any serious health problems?
If yes, please explain:
19. What procedure will you use for housebreaking?
If other, please explain:
20. What plans do you have for obedience training?
If other, please explain:
21. Do you currently have any pets?
If yes, please list type, name, age, sex and breed:
22. How many pets have you owned in the past 5 years?     
Where are these pets now?
If any of these pets are not still with you, please explain:
23. Have you ever had a serious behavioral problem with a pet?
If yes, please explain:
24. Has a dog died on your premises of distemper, parvovirus, or other causes in the last 3 months?
25. Have you ever adopted a pet from Ruffus Rescue or any other animal shelter / humane society or rescue group?
If yes, when and what happened to this pet?
26. Do any of your current or did any of your past pets live primarily outdoors?
If yes, please explain:
27. Where will your new pet primarily stay?
28. Will the new pet have access to the entire house?
If no, where will this pet be allowed?
29. Where will the new pet stay when home alone during the day?
If other, please explain:
30. Where will the new pet sleep at night?
If other, please explain:
31. Will your new pet be allowed on the furniture?
32. Are all your current pets (if any) spayed/neutered?
If no, please explain:
33. Are all your pets vaccinations up to date?
34. Do you know how to protect your pet from heartworm disease?
35. If you currently have a dog, does he/she take heartworm preventative medicine?  
If yes, what kind?
36. Do your current pets wear ID tags?
If no, please explain
37. How do you plan to protect your new pet from fleas and ticks?
38. Do you have a current veterinarian?
Vet's name:
Vet's phone number:
Can we contact them for a reference?
39. Do you plan to take your new dog to the veterinarian for full preventive and medical care at least once a year?
40. How much do you expect annual pet care to cost?(e.g. veterinarian costs, medication, vaccines..etc)
41. Who will be responsible for the daily care of this new dog?
42. What is the longest period of time your new pet will be home alone on an average day?
43. Do you have a pet door?
If no, would you consider installing one (if necessary)
44. Is there a yard available?
If yes, is it fully fenced without gaps?  
Fence Height?
45. If there is no fence, would you consider fencing all or part of the yard as a condition of adopting a dog?
46. If there is no fence, how do you plan to keep your new dog on your property when outdoors?
If other, please explain:
47. Do you have a doghouse or other outside shelter?
48. Under what circumstances do you think it is OK to leave a pet outside in an unfenced area without supervision?
(check all that apply)
49. What do you plan to do with your pet when you go on vacation?
50. If you date or marry someone who does not            want your pet(s), what would you do?
51. If your pet develops a serious medical condition which becomes expensive to treat, what would you do?
If other, please explain:
52. If your pet develops a frequent urination problem when it is older, what would you do?
If other, please explain:
53. What circumstances would justify giving up your pet? (check all that apply)
If other, please explain:

By checking this box, I am attesting to the truthfulness of my answers. Falsification of any of the above information will be grounds for disallowing the adoption of rescue animals and possible removal of said animals from my home.
click on button below to submit your application