Lucky Lab Rescue Adoption Application Form This form must be completed to be considered for adoption. After completeting the form,click on the SUBMIT button. * indicates required fields    *Applicant Name (first & last):   *Occupation:   Co-applicant Name (fisrt & last):   Occupation:   Relationship to Applicant:   *Address:   *City, State, Zip:   *Home Phone:   Cell Phone:   Work Phone:   *E-mail:   How long have you lived at your present address?:   *Do you own or rent?:  Own  Rent   *Your residence is a: House Apartment Condo Townhome Mobile Home Other   If other, please explain?:   *Do you have a fenced yard?:  Yes  No   If yes, type & height:   *Do you have children currently living at home?:  Yes  No   If yes, whare their ages?:   *Are you looking for a:  Housedog  Outside dog   *Why do you want to own a rescue dog?:   *How soon would you like to adopt?: Now 2-4 weeks 1-3 months 6+ months   *Have you ever owned a dog before:  Yes  No   If so, what happened to the dog?:   *Have you ever given away any of your pets?:  Yes  No   If yes, please explain?:   *Do you currently own a dog(s)?:  Yes  No   If so, what breed(s)?:   Age(s)?:   Gender(s):  Male  Female  Both   *Is your dog(s) spayed and/or neutered?:  Yes  No  Do not currently own a dog   *Are these pets all up to date on shots?:  Yes  No  Not sure  Do not currently own a dog   If no, why not?:   When was your pet(s) last at the Vet & why?:   *Do you have any cats?:  No  Yes   *Any other animals?:   *Vet reference (Clinic, address, phone):   *How many hours will your be alone per day?:   *Where will your dog be kept when you are not home?:  Loose indoors  Loose outdoors  Crate indoors  Fenced yard  Outside kennel run  Basement  Tied outside  Garage  Other   If other, please explain:   *When you are home, where will the dog be kept?:   *Where will the dog sleep?:   *How often do you travel?:   *Where will the dog be when traveling?:   *What type of exercise do you plan on providing?:   *Are you willing to crate train?:  Yes  No  Maybe   *Are you willing to attend obedience classes?:  Yes  No  Maybe   *Are you willing to have a home interview?:  Yes  No  Unsure   *Have you ever applied to other rescues?:  Yes  No   Which rescue(s) & their website address(es):   Did you adopt from them?:  Yes  No   If not, why?:   *Describe your ideal Lab (color, gender, age, etc.):   *Would you be willing to adopt a Lab mix?:  Yes  No  Maybe   *How did you hear about us?: Petfinder.com Referral Adop-a-Pet.com Search engine Car bumper magnet Lucky Lab website Other   If a referral, name and phone number:   *List a personal reference (name, phone, email):   Dogs you are interested in on our website:   Notes/comments:: After filling the details click on the SUBMIT button.

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