RAINCOAST APPLICATION FORM (Download Form) Your Information Your Name* Our application process is very efficient. Please apply only when you are ready to welcome a rescue dog into your home. When will you be able to welcome a dog into your home?* JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 203020292028202720262025202420232022202120202019 City* Address* Province* Home Phone* Cell* Email* Your Age* Spouse Name if applicable Spouse Age If relationship were to change who would the dog remain with? Your Past Animal History Your experience with animals? Please explain. Do you have experience with rescue animals? Please explain. What is your experience with Bully Breed or Pit Bull type dogs? Are you willing to work with any behavioural issues? (ie. reactivity, separation anxiety, fearfulness, potty training etc.) YesNo Do you currently own any pets? If so, what breed, age, sex and if they are fixed. Please list all animals living in the household. Please be detailed and clear. If applicable. What is your current dogs diet like? ie: Kibble? Raw? Cooked? What type of diet do you plan on feeding your new dog? How much exercise do you plan on giving your adopted dog on a daily basis? Have any of your previous dogs have behavioural issues? if so, how did you address them? Home Information Who else lives in household? Please include children’s ages. Do all the people living in the household want to welcome a rescue dog into the home? YesNo Who in the household works? (Full Time/Part Time) Is anyone in the household allergic to dogs? Residence Background Residence Type: If renting, what name is the lease under? May we contact your landlord to verify permission for having a dog? If yes, what is your landlords name and phone number? Own or Rent?: What is your relationship like with your neighbours? Do your neighbours own any dogs? Do they keep them safety fenced or indoors? About Your Yard Do you have a fully fenced in front-yard? YesNo What type of fencing for the front and back? Do you have a fully fenced in backyard? YesNo How high are the fences? About You Tell us a little about your lifestyle so that we may help pair you up with the right dog. (Do you jog, have a lot of social activities at your house, couch potatoes, etc?) Under what circumstances would you chain up a dog? Under what circumstances would you give up a dog? Have you ever surrendered a dog before? YesNo What dog day cares (if any) have you used in the past? May we contact them for a reference? Do you already have a veterinarian? If yes, who? Please list one other reference that is not a relative. Name, phone number and relationship to the applicant(s). Name Phone Number Relationship About Your Potential New Dog Is there a specific breed(s) are you interested in? What characteristics made you choose this particular breed(s)? I am interested in adopting a dog that fits the following profile Please describe the ideal type of dog you are in? Breed, age, sex, temperament etc? If you are interested in a specific dog we have up for adoption? What is his/her name? Indoor or outdoor dog? indooroutdoor Where will the dog sleep? How much time will dog spend home alone? When you go to work where will dog stay? Are you aware that there is an adoption fee to be paid as a deposit in cash or via e-mail transfer the day you start the “foster-to-adopt” period with your new dog? YesNo If you are interested in fostering ONLY there are no fees involved, please indicate if this is your intent. YesNo Do you understand that all vaccinations are covered up to date of the adoption and spay or neuter is covered if the dog is over 6 months old? (Please note: Some may be required after this date at the adopters expense.) YesNo Do you have any physical or mental conditions which may impact your ability to care for a pet? YesNo How did you hear about RainCoast Dog Rescue? Is there anything else you would like to add?