ROCK Rescue Adoption Application
Please Answer All Questions; We Will Not Process Applications That Have Not Been Completely Filled-out.
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1. What Is Your Full Name and Age?
2. Please List Name and Description (Cat/Dog, Breed, Color) of Pet You Want to Adopt.
3. Why Do You Want to Adopt This Particular Dog or Cat?
4. What Is Your Complete Address, Including Street, City, State, and Zip Code?
5. What Are Your Phone Number(s)? Home:
Cell:
Work:
6. Please List the Names & Ages of All Persons Living in Your Home:
7. What Is Your Email Address?
8. What Is Your Drivers License No., Including State?
9. What Vet Do You Currently Use or Plan to Use?
Please Include the Address and Phone No.
10. Please List 2 Non-Family References with Phone Nos. 1st - Name and Phone No.:
2nd - Name and Phone No.:
Do You Grant Rock Rescue Permission to Contact Your Vet and References? Yes  No 
11. What Type of Home Do You Live In: House  Apt  Town-House
Condo  Mobile-Home
12. Do You Own or Rent (Please Type In: own or rent):
13. How Long Have You Lived At This Address?
14. Is Your Yard Fenced? Is It Directly Accessible From Your Home? Please Describe Fence and Yard:
15. What Type of Exercise Will You Offer Your Pet?
16. How Many Hours Per Day Will The Pet be Left Alone, and Where Will He/She be Kept When Alone? Where Will the Pet be When You are at Home and at Bedtime?
17. Will Your Pet Be an Inside or Outside Pet?
18. Please List Pets You Have Had In The Past. Where Are Those Pets Now?


19. Do You Currently Own Other Pets?
Yes  No
If You Currently Own Pets, Please List Each Pet's Breed, Age, and Sex:


20. Are All Your Pets Current on Vaccinations and Spayed or Neutered?
21. Is Your Family Willing To Work With A New Pet On Any Issues That He Or She May Have?
22. What Method of House-training Will You Use, if the Pet You Adopt Does Not Seem to be House-trained?
23. What Questions, Concerns, or Further Explanations Would You Like to Share With Us?
ALL OF THE INFORMATION I HAVE PROVIDED ON THIS APPLICATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND COMPLETE. I UNDERSTAND THAT FALSIFYING ANSWERS ON THE APPLICATION, OR AT ANY OTHER TIME DURING THE ADOPTION PROCESS, DISQUALIFIES ME FROM ADOPTING THIS PET.
(Please type in yes or no. We Will Require You To Sign a Print-out of This After Your Application is Approved.)





Please Allow One Week To Process Your Application. If You Do Not Hear From Us By Then, Please Email Us:
(rockrescue06 at aol dot com). Please Click SUBMIT Now. It Will Email Your Application to Us, Then Return You to Our Home Page. Thank you!