Lap Dog Rescue of NM

Adoption Application

Applicant Information
Applicant Name *
Address *
City State Zip *
,
Email *
Home Phone *
Cell Phone
Work Phone
Pet Information
Physical description of the pet
Any details for the type of pet you are looking to adopt
Optional: Select any specific breeds you are interested in.
The purpose of this dog is: *
Other:
LDRNM History
Previous LDRM Adopter?
*
Adopted Dog Name
*
Year Adopted
Adoption Request
Do you have a gender preference?
*
Gender Preference
*
Reason for gender preference
Size
*
Any age preference?
*
Temperament
What activity level best suites your home?
*
Other Activity Level Explained
*
Have you ever owned this breed/mix before?
Are you familiar with this particular breed/mixes? (e.g., grooming requirements, future special medical needs, etc?)
Will you be a first time dog owner?
*
Household Pet Information
Do you currently have other dogs living in your home?
*
List all of your current dogs with their age and breed.
Do any of your dogs have health, behavioral or dominance problems?
*
Please describe
Are all of your dogs Spayed/Neutered?
*
Are all of your dogs vaccinations up to date?
*
Have you had a dog or cat with an infectious disease, or one who has come into contact with another infected animal within the last 6 months?
*
What type of infectious disease?
Have you ever had a pet euthanized (put to sleep), lost a pet due to an accident, had a pet that ran away, was lost, stolen or given to a shelter or a rescue?
*
Please Explain
*
Other Animals
Do you have other animals?
*
List all of your other pets and how long you've had them.
*
Veterinarian Information
Do you have a veterinarian?
*
Phone #
*
Veterinarian Name
*
Address
*
Work Information
Are you over 21 years of age?
*
Are you retired?
*
Occupation
*
What are your hours?
*
Do you work at home?
*
Household Information
Do you have children permanently in your home
*
List all of the ages of the children in your home.
*
Have the children had or been around animals
*
Do you have children temporarily visit your home?
*
List all of the ages of the children who visit your home.
*
How many adults live in your home?
*
Do you own or rent your home?
*
Do you have written permission from your landlord to have a dog?
*
Landlord Name
*
What type of home do you live in?
*
Other home:
*
Do you have a fenced yard?
*
Height of fence
* ft
Type of fence:
*
Other fence type
*
Does your apartment have a fenced patio
*
What type of fenced patio?
*
Other type of patio fence
How tall are the patio walls?
* ft
Are there any community restrictions on the number, size or breeds of dogs?
*
Are you within those restrictions by adopting a dog?
*
How will your new dog spend its days?
*
How will your new dog spend its nights?
*
Do all members of your family know that you plan to adopt an animal?
*
Additional Information
Select any issues that would prevent you from adopting a dog
If "Other", Please explain
What steps will you take to integrate your new dog to existing pets and family members to ensure a successful transition? What would you do if your new dog has trouble getting along with current pets or family members?
*
Are you willing to take your dog to training classes if needed?
*
It may take some time to find the right match for your family. Are you...
*
What would you do with your animal should you have to move from your present address?
*
What do you do with your animals when you go on vacation?
*
Comments
Any additional comments
The Fine Print

  • Adoption Process. There is NO obligation that the applicant must adopt the dog for whom they have applied. There is NO obligation by LDRNM to adopt that or any dog to the applicant. The receipt of an application for a dog is NOT an implied guarantee the applicant will be selected to adopt that dog. Adoption decisions are a subjective process driven by the foster who best knows the personality and needs of the dog and whose goal is to find the best home for the dog. You may be asked for references.

  • Sterilization. Mandatory with exceptions only made due to age or health and supported by a statement by a licensed veterinarian. 

  • Home Visit: All adoptions require an application and a home visit by appointment. Vet records may be checked as necessary. References may be asked for. An adoption fee ranging from $175 to $300 will be required at the time of completion of the Adoption Agreement. LDRNM cannot be held liable for any hazard or damages a new dog may present to known or unknown adults, children, any other animals or property. Any health issues that might arise as a result of the care provided after adoption will be the financial responsibility of the potential Adopter. 

  • Application Certification. All of the information I/we provided on this application is true and correct. If any of the information changes, I/we will advise you promptly.


Date: 10/19/2017