‘New Leash on Life!’ American Eskimo dog Rescue

Foster/Adoption Application Form

____________________________________________________________________________________

New Leash on Life Animal Rescue; PO Box 555, Somerset, TX 78069 Phone: 210-410-7334

www.nlol.net

Thank you for taking the time to fill out this application. This is a combined Foster Home and Adoption Application. Please answer ALL the questions in this application with your ultimate goal in mind, whether it is to foster or adopt a Rescued Dog. If a question does not apply to you, please write N/A in the response area.

Please fill out this form completely and clearly. Please include area codes with all phone numbers, and please include your E‑mail address, if at all possible. One of our representatives will be contacting you shortly after we receive your application.

Mail your completed Adoption/Foster Home Application to:

Adoption Application

New Leash on Life!

PO BOX 555

Somerset, Texas 78069

NOTE: Postage is generally $.60 cents to mail this application.

General Questions about Rescue and Adoption or to email this application: please e-mail to: NewLeashonLife@att.net

ABOUT YOU AND YOUR FAMILY

Contact Information:

Today's Date: Name/ID Of Pet

Name:

Address:

Mailing Address, if different from above

Address: _________

City: State: Zip:

E-mail:

Home Phone: Work Phone:

Cellphone: _____ Alt.phone: _____

Occupation:

Are you a student or active military?

Spouse’s Occupation:

Are you interested in Adopting, or Fostering? Please “X” the appropriate response:

____ Adopt

____ Foster

Please indicate the following about your household:

Number of other people living in your home:______________

How many adults

Number of Men?______ Number of Women?____Number of children?

Please list all people in household: Give names and ages of everyone

Do you have children or grandchildren who live with you? YES NO (circle one)

Number of boys______ Ages __________

Number of girls ______ Ages __________

Are there any other residents in the house?

Are there other animals or people who regularly visit your home (parent's dog, neighborhood children, relatives, etc.)? YES NO (circle one)

If YES, please describe:

Animal Type (dog, cat, etc.)

Breed

Gender (M/F)

Age

Spayed/Neutered

Are all the pets present in your household up to date on their vaccinations? YES NO

Do you have any immune-compromised pets? YES NO

Are there any special-needs pets in your household? YES NO

If adopting or fostering,, are ALL household members in complete agreement to adopting, caring for, and training a Rescued American Eskimo/mixed breed Dog? YES NO

Do any family members have allergies related to pets? YES NO

Part of agreeing to foster or adopt an rescued dog may include an in-home visit when all people and animals in the home are present. When would be a good time for us to schedule a home visit? __________________________

Tell us about your family life: Active? Calm? Rowdy? Other? ________

Please Explain: ___________________________________________________________

Do you live with your parents? or In-laws?

If so, is it their home or yours?

Non-Related Personal References:

1. Name Phone# Relationship: Yrs. Known

2. Name Phone# Relationship: Yrs. Known

YOUR EXPERIENCE WITH PETS

I consider myself:

· an experienced American Eskimo Dog person (current or previous Eskie owner) _________________

· an experienced dog owner (please list current or previous breed experience) ________________

· somewhat experienced with dogs ______________________

· novice dog owner _______________________________

If you do not currently have a pet, have you owned a dog before? YES NO

What happened to your previous dog(s)?

Have you ever adopted a a Rescued American Eskimo/mixed breed Dog before? YES NO

If YES, from what Rescue organization? ___________________________

Have you ever had to relinquish a dog? YES NO If YES, what were the circumstances? _______________________________________________

Have you ever bred a dog? YES NO

Have you raised a puppy before? . ____Yes ____No From what age? (weeks, months, etc.) _________________When? (year) _____________

How long did you keep the dog?_______________________________

If you did not keep the dog as a family pet, why was it relinquished? _________________________________

While being raised, where did the puppy spend most of its time?

_______________________________________________________________________________________

What methods were used to socialize and train the puppy? (owner training, obedience school, other) _____________________________________

What program of socialization and training do you anticipate using if you adopt a dog? ________________________________________________

If you have raised a puppy before, please describe that experience. If not, please explain why you would like to adopt a puppy now. Use an extra sheet of paper if desired. ______________________________________________

Are you familiar with the American Eskimo Dog breed? YES NO

Please give the year when you acquired and, if now gone, lost your last Eskie:

________________ Year Acquired (Example: 1992)

________________ Year Lost (Example: 2002)

If you have an a Rescued American Eskimo/mixed breed Dog presently, why do you want to foster or adopt another a Rescued American Eskimo/mixed breed Dog?

Please list all pets: Give names, breeds, sizes, sex, ages & how long you have had your pet

What kind of personality does your dog have?

___ Dominant/Aggressive ___ Docile/Easy-Going ____Other-explain fully:

Are your pets spayed /neutered? Yes: No:

Are your pets up to date on all shots? Yes: No:

DHLPP______Rabies_______Bordatella______Other___________

Are your pets on heartworm preventative? Yes: No:

Type of Heartworm meds.?__________________________________

Are they on flea/tick preventative? Yes: No:

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

Yes: No: if so who ?

Ever given up a dog in the past? Yes: No: If yes, what were the circumstances?

Ever euthanized a dog in the past? Yes: No:

If yes, what were the circumstances?

What other pets have you owned in the last 5 years?

If you have current pets, or have owned a pet before, may we contact your preferred veterinarian?

YES NO

Name, address and phone number of current or last veterinarian:

1. Vet Name Vet Address

Vet Phone # Date of last visit

2. Other Vet Used: Name Vet address

Vet Phone # Date of last visit

If you have never had a Vet:

1. Employer’s Name Phone# Yrs. Known

2. Pastor Name Phone# Yrs. Known

ABOUT YOUR HOUSEHOLD

Please indicate the following about your home:

What kind of area do you live in? city____ suburb _____ rural_____

Is your home close to or on a main street or highway? Yes: No:

Do you rent? How Long At This Address?

Do You Own? Do you have proof of ownership?

What type of home do you live in?

[ ] Own home [ ] Rent home

[ ] Condo/Townhouse [ ] Apartment

[ ] Mobile home [ ] Other

How long have you lived at your present address? _______Years _______Months

If less than one year, give previous address.

Address:

City: State: Zip:

If you live in a mobile home do you own the land or rent it?

How many animals are you legally allowed to have on your property?______

If you rent, do you have the permission of your landlord to keep a dog? YES NO

Will you show me the landlord’s written

If yes, please include a copy of written permission that you can keep a dog (or dogs) on the premises. This must be included with this application or your application will be denied.

May we have permission to contact your landlord? YES NO

List landlord's

name: address: phone:

How many stairs are in the home?

__________ From Street to Front Door __________ From Main Floor to Yard

__________ From Main Floor to Second Floor __________ Other

__________ From Main Floor to Basement

Do you have a doggie door? YES NO

Do you have a fenced yard? Yes: No:

Height of fence:

Please describe the fencing: Height: _____ feet

Type/Material: Block Wood Chain Link Other explain fully:__________________________________

Do you lock your gates? YES NO

Does your fencing completely enclose a yard? YES NO

Describe your yard:

Approximate size:______ feet by ______feet

Grass? YES NO

Gravel? YES NO

Trees? YES NO

Bark Dust? YES NO

Dog door access? YES NO

Separate Kennel/run? Yes: No:

Approximate size: ______feet by ______feet

Do you have a spa? YES NO If YES, is it kept covered when not in use? YES NO

Do you have a swimming pool or pond? YES NO

Is it fenced? YES NO

If YES, describe type of fencing: _________________

Are you aware that some Rescued American Eskimo/mixed breed Dogs enjoy swimming and if you have an unfenced pool or pond, the Rescued American Eskimo/mixed breed Dog may try to swim in it? YES NO

How do you plan to train the Rescued American Eskimo/mixed breed Dog to get out of the pool or pond?

If you moved, what would you do with the dog?

May I visit your home? Would you agree to a ‘New Leash on Life’ Animal Rescue representative visiting your home to see how and where the animal would be living and to inspect prior to and after adoption for safety issues and guidance for possible pet problems? Are you willing to have a home check before adoption? Yes: No:

THE PERFECT RESCUED DOG FOR YOU

Please indicate the following about the pet you are interested in:

What 'specifics' are you looking for in a Pet? _______________________________________

What gender dog do you prefer to foster or adopt? Male____ Female _____ Either _______

What is your age preference?

Age: less than 1 year. 1 to 3 years. 3 to 5 years. Older dog.______ Why? _______________

Coat length/type: long? short ? dense?____ fluffy?____ thin?____ straight?_____

Please describe the characteristics/behaviors you would like your Adopted Dog to have. (Specify which attributes are requirements and which are merely desirable.)

Please rate the following canine traits in the order of most displeasing to least displeasing.

(1 = MOST displeasing to 7 = LEAST displeasing). Put a “7” for each trait that does not bother you.

_____Barking

_____Chewing

_____Digging

_____Drooling

_____Jumping

_____Odor

_____Shedding

Please briefly state why you would like to add an Rescued American Eskimo/mixed breed Dog to your family:

Why are you wanting to adopt & What do you expect in an Rescued American Eskimo/mixed breed Dog companion? Check all that apply & please explain:

protection: breeding: _____ child's friend: companion/friendship:

gift: ___ guard dog: ___ obedience/agility: ___ appearance___ hunting___

other: ____________

If adopting as a gift, would the person accepting this dog be willing to comply to all adoption procedures? Yes No

Activity Indoors:

Are you aware that a Rescued American Eskimo/mixed breed Dogs are 'people' dogs and will want to live inside with their human family? YES NO

Some dogs are lively and curious in the house, they like to play with you and follow you around. YES NO

Some dogs lie down most of the time. YES NO

Do you think that an active dog will annoy you? YES NO

Will it annoy you if the Eskie gets up on your sofa or your bed? YES NO

If YES, how would you train the dog not to get on the furniture?

What type of personality/activity level are you comfortable with in a dog?___________________

Would you be willing to foster or adopt a dog with health problems?

YES NO MAYBE

Would you be willing to foster or adopt more than one dog at a time (littermates or dogs that cannot be separated)?

YES NO MAYBE

Would you be willing to foster or adopt a senior dog (10+ years old) or special needs dog?

YES NO MAYBE

Would you be willing to foster or adopt a very young Eskie or a puppy?

YES NO MAYBE

Do you wish to be placed on a waiting list for a particular breed of dog?

Yes: No:

Why are you considering an American Eskimo Dog as opposed to other breeds?

Would you be willing to have another breed or a mixed breed American Eskimo Dog? Yes: No:

Please explain:

CARING FOR YOUR RESCUED DOG

Who will be responsible or be the primary caretaker for the animal?_______________________

Which members of your family will feed/care for the Pet?

Housebreaking: __________ Socialization: __________ Feeding: __________ Household & Social Behavior __________

Grooming: __________ Obedience Training: __________

What is your idea of proper and nutritious food for a dog? _______________

Does everyone in your household want an American Eskimo Dog or Rescue Dog? Yes: No:

Are you willing to housebreak the dog? Yes: No:

Where will the Adopted Dog live & sleep? Explain fully:

Where do your current pets live & sleep? Past pets? Explain fully:

How will you exercise your Adopted Dog? How often?

Daily walks Fetching Jogging Hiking Swimming Run Free in Backyard Dog Park Other (describe):

Will this dog be primarily an indoor or outdoor pet?

Indoor: Outdoor:

How long are you gone each day? ______

This Pet would be alone for hours per day.

Where will you keep the dog while you are at work or out on errands?_________________

When the dog is outside, will he/she be supervised? Yes: No:

Will the dog ever be chained? Yes: No:

During the day, the Pet would be in the

House Yard Garage Other

Please specify other:

During the night, the Pet would sleep in the:

How often do you travel? _____

When you go away for a few days, who will care for the dog?

Kennel Friend's house Trainer Groomer Vet

Other (describe):

What type of vehicle(s) do you own?

How will you transport the dog in a vehicle?

Will you keep a collar on your dog? YES NO

If YES, describe (buckle-type, quick-release type, chain-type, etc.):

If NO, why not?

ID Tag? YES NO Microchip? YES NO License Tag? YES NO

How much grooming are you willing to do?

None Daily Weekly Monthly

How much adult supervision of dog and child will be provided? (Circle one)

Total Some Minimal None

With neighborhood children? (Circle one)

Total Some Minimal None

T = Total S = Some M = Minimal N = None

Are you willing to take your American Eskimo Dog or Rescue Dog to a veterinarian for an annual physical and vaccinations? YES NO

Are you willing to have your American Eskimo Dog or Rescue Dog tested annually for heartworm? YES NO

Will you deal with health issues, if the dog needs special care later in life?

Yes: No:

Please explain:

TRAINING YOUR RESCUED DOG

If adopting, will you agree to take the dog to obedience classes if recommended by the Adoption Director?

YES NO

Have you ever completed an obedience class with a previously owned dog or current dog? YES NO

If yes, what were the training techniques you learned?

Do you understand that Eskies are a very intelligent breed and that some of the Rescues will come with minimal training and may need a large amount of patience? YES NO

Some of the rescued Eskies or Rescue Dogs have been backyard dogs and are therefore not housetrained.

Have you ever housetrained a dog before? YES NO

Are you comfortable with having to housetrain an Eskie or Rescue Dog ? YES NO

Even some housetrained Eskies or Rescue Dogs will have accidents in the house for a while after they come into an unfamiliar home. What steps will you take to help your Eskie/Rescued dog avoid such accidents?

If your Eskie/Rescued dog is not already housetrained, what housetraining methods do you plan to use with your Eskie/rescued dog?

Some Eskies/Rescued dogs have been left in backyards by neglectful or untrained owners and have developed anxiety to thunderstorms or loud noises in general. Have you ever dealt with a dog with "noise anxiety?" YES NO

Are you willing to read some information on behavior modification and work with the rescued Eskie/Rescued dog to overcome such anxieties? YES NO

Due to their “history,” some Rescued Eskies/dogs have developed separation anxiety. Have you ever dealt with such a dog? YES NO

If NO, would you be willing to read some information on behavior modification and work with the dog to overcome this problem? YES NO

Some rescued Eskies/rescued dogs come from physically abusive homes and are extremely timid and have a condition called "submissive urination." Usually this condition lasts only a few days. Once the Eskie/rescued dog knows he is in a home where he will not be beaten or abused and his self-esteem and confidence return, this problem usually takes care of itself. However, if it does not, are you willing to read some information on behavior modification to help the Eskie/rescued dog overcome this condition? YES NO

What is your opinion on formal obedience training classes?

*Are you willing to enroll or attend at least one session of obedience classes with your adopted dog as needed or recommended? Yes: No:

How do you feel about crating a dog? Approve______ Disapprove________

If NO, why not?

Are you familiar with crate training? Yes: No:

And what are your thoughts regarding crate training or crating a dog?

What type of crate would you use if crating? And how large compared to dog?

How often would you use a crate for the dog? And Why?

Have you applied with another rescue organization in your search for your new family member? It helps us to realize this when trying to coordinate our volunteer efforts. Please name the rescue and mark the appropriate response.

***I have an application currently submitted with another rescue.

***I applied with another rescue but did not adopt.

***I have never applied with another rescue organization.

***Other…please explain:

Additional Information and Comments, you would want to add?:

Transporting ~

Dogs placed through New Leash on Life are generally done so on the basis of proximity of the dog to the adoptive home; however, we may transport dogs interstate.
Please tell us if you are willing to:

*Pay airfare costs to transport a dog interstate to you? (approx $120-170 - NOT available in summer)

*Drive interstate to pick up a dog? Yes: No:

Donations
*All our ‘New Leash on Life’ dogs are spayed/neutered, vet checked, up to date with shots and evaluated before they are placed. These expenses can vary for each adoptable; and usually start at $200-300, we do ask for donations to cover these costs of vetting and getting our rescues ready for adoption. Each dog has a different amount that we actually spend on them depending on what their needs are, and All donations are used to help our present and future pups that are in need. You must remember our main purpose is to get these rescues healthy and in the best forever homes that we can find!

NOTE: Are you aware that the Donation for this dog(s) will be the least of your expenses during his/her lifetime? Expenses include good nutrition, annual vet exams and shots, and grooming. YES NO

Are You Aware That

*Routine care of a Pet may cost $100 to $500 or More per yr? Yes: No:

*That some Pets shed profusely and some of them drool or slobber. Yes: No:

*When you adopt a Pet, you're taking responsibility for its lifetime, up to 14 years?
Yes: No:

*Do you understand all of the expenses involved with caring for a dog, especially as it ages? (Including but not limited to ordinary and emergency veterinary expenses, heartworm preventative, grooming, etc.)

Yes: No:

*Do you understand that “New Leash on Life!” Animals ARE NOT OUTSIDE PETS? Yes: No:

*Do you understand that there are no guarantees about the behaviors, temperament or health of a dog that is adopted and that the adjustment period varies for each dog? Yes: No:

*Do you understand the need for these donations and the fact that all donations are

NON-REFUNDABLE even if it ‘doesn’t work out’? Yes: No:

Do you agree to the following?:

*If you are ever unwilling or unable to keep an Adopted Dog received through ‘New Leash on Life’ Animal Rescue, the dog must be returned to ‘New Leash on Life’ representative, Carol Raymond? Yes: No:

*Keep current license and ID tags on dog at all times? Yes: No:

*The dog should never be left outside unattended? Yes:____ No: _____

*The dog should never be allowed off lead in open places without proper safety confinements? Yes: No:

*Provide timely health care for dog? Yes: No:

*Restrain dog in any vehicle, i.e. car, pickup truck or convertible at all times? Yes: No:

*Adoptive homes must forward all paperwork with appropriate signatures to ‘New Leash on Life!’ Animal Rescue within five business days of completion.

Are you able to comply with these requirements? Yes: No:

OTHER ITEMS

Would you like to become involved in American Eskimo Dog Rescue? YES NO

How did you hear about New Leash on Life! American Eskimo Dog Rescue? ______________________

For people interested in FOSTERING: APPROVED-TO-FOSTER HOMES MAY INDEED ADOPT THEIR FOSTER ESKIE!!! Foster families who choose to adopt a foster must fill out the appropriate paperwork, including contracts, and to pay the adoption donations as we do need the donations to cover vetting expenses etc.

We appreciate the time it took to fill out this application. Thank you so much for offering to open your home to give an Eskie/Rescued dog a second chance. Our foster homes are the most important link in the Rescue chain. If your application is approved, you will be entered into our database for families interested in fostering Rescued Eskies/dogs. The Foster Home Coordinator will use the information you provided to assist us in placing a dog in a foster home. You will be contacted by the Foster Home Coordinator when a dog needs a foster home.

For people interested in ADOPTING: Thank you for your interest in adopting one of our Rescued Dogs. We appreciate the time it took to fill out this application. If your application is approved, you will be notified by either E-mail or a phone call. If you are approved, then after your approval notification, you will be called to schedule a home visit and then placed on our waiting list to adopt one of our rescues as they come available for adoption. If your application is approved, the Adoption Team will carefully match your lifestyle and needs with an available Eskie/Rescued dog ASAP, depending on the waiting list.

If you get a Eskie/Rescued dog from another source, or change your mind about adopting from us for any reason, please notify us so we can remove you from our list.

GENERAL AGREEMENT

I am at least 18 years of age. All of the information I have given is true and complete. I understand that New Leash on Life! American Eskimo Dog Rescue has the right to refuse my application.

* Note: In "submitting" this application, you are in effect attesting to the following statement:

All of the information I have provided in this application is, to the best of my knowledge, true and complete. I understand that falsifying answers in this application, or at any other time during the adoption process, disqualifies me from adoption.

Applicant's Signature:______________________________________ Spouse's Signature: _____________________

Send your completed Adoption Application to:

‘New Leash on Life’ Animal Rescue

PO Box 555,Somerset, Texas 78069

Or Email it to: NewLeashonLife@att.net

*** ALL DONATIONS ARE NON-REFUNDABLE ***
ALL APPLICANTS ARE SUBJECT TO A HOME VISIT. WE RESERVE THE RIGHT TO REFUSE OR REJECT ANY APPLICATION. IT MAY TAKE SEVERAL DAYS FOR YOUR APPLICATION TO BE REVIEWED, DEPENDING ON THE VOLUME OF APPLICATIONS RECEIVED. PLEASE BE PATIENT. YOU WILL BE CONTACTED AS SOON AS POSSIBLE.

Your patience is greatly appreciated.

Your interest and desire to adopt a rescued dog is appreciated even more!

____________________________________________________________________________________

FOR RESCUE USE ONLY

Fostering/Adoption Application Received:

Application Fee ____

Phone Interview to go over Application Questions ___

Transporting Arrangements ____________________________________

Vet References Called ___

Personal References Called ____

Renting Applicants - received written permission ____

Home Visit Recieved _____

Sent Breed Info PDF____

Sent Basic Training Info ___

Sent Crate Info Brochure ____

Sent House Training Info ____

Sent FAQ about Fostering ___

Referred to Foster Trainer____

Agent'sName________________________________________

Approved Notified _____ Denied Notified________