CPR Application p. 1
Carolina Poodle Rescue - Adoption Application www.carolinapoodlerescue.org
Thank you for your interest in adopting a rescued dog! Once your application has been received and approved, we will do everything in our power to assist you in adopting a companion that will be an excellent fit for your family and truly your forever dog. Please be careful to answer each question fully as we cannot process your application otherwise.
Please note:
1. We do not adopt our pets to homes where children under 5 years old live. It is for the safety of the child and the pet. You can find detailed information about why we have this policy on our webpage: Why We Don't Adopt to Families with Young Children.
2. If you would like to adopt a standard poodle but do not have a physical fence (underground or electronic fences are not considered sufficient, please review our criteria for this.
After you have completed this application, please email it as an attachment to: [email protected].
* Denotes required fields
Part 1. Applicant Contact Information:
Applicant's Name: *
Residential Street Address: *
City, State, Zip: *
County: *
Email Address (Please type carefully!): *
Home Phone: *
Cell Phone:
Work Phone: (For emergencies only):
Place of employment:
Part 2. Type of dog desired
Why do you want to adopt a dog?*
What variety/size of dog? Standard (Large) Mini (Medium) CPR Application p. 2
(Poodles come in Toy, Mini, and Standard varieties. Also Toy (Small) Non-poodle we often have non-Poodles available.) Not sure yet / Open
If there is a specific dog that you want, what is its name?
If you are interested in a specific dog but that dog has already been adopted, would you consider another? Yes No Maybe
What age dog are you interested in adopting? Puppy Adult
Senior Not sure yet / Open
Are you flexible in your age requirements? Yes No Do you prefer a male or female? Male Female Either If your sex preference isn't available, are you willing to adopt the opposite sex? Yes No Not sure
Part 3. Pet Ownership Experience
7. Current Pets - What pets live in your home now? Please list ALL of your CURRENT pets:
I have no pets right now. If you have no pets currently, please check the appropriate I had pets previously, but don't have any right now. box then move on to the next section. If you have selected one of the above, please move on to the next section (Previous pets). Pet CURRENT PET #1 INFORMATION: #1 Pet 1 Name
Breed: Poodle Other breed:
Small (under 15 lbs) Size/weight: Medium (15 -35 lbs) Large (over 35 lbs)
Age: Puppy Adult Senior
Sex: Female Male
Spayed Neutered Please check one: Not altered If not altered - can you tell us why?
How this pet will get along with a new dog? Will get along fine May need some time to adjust Do you anticipate any problems? CPR Application p. 3
Other:
Indoors Outdoors Kennel / Run Describe where this pet lives and spends most of its time: Other:
Pet CURRENT PET #2 INFORMATION: #2 Pet 2 Name
Breed: Poodle Other breed:
Small (under 15 lbs) Size/weight: Medium (15 -35 lbs) Large (over 35 lbs)
Age: Puppy Adult Senior
Sex: Female Male
Spayed Neutered Please check one: Not altered If not altered - can you tell us why?
How this pet will get along with Will get along fine May need some time to adjust a new dog? Do you anticipate any problems? Other:
Indoors Outdoors Kennel / Run Describe where this pet lives and spends most of its time: Other:
Pet CURRENT PET #3 INFORMATION: #3 Pet 3 Name
Breed: Poodle Other breed:
Small (under 15 lbs) Size/weight: Medium (15 -35 lbs) Large (over 35 lbs)
Age: Puppy Adult Senior
Sex: Female Male Please check one: Spayed Neutered CPR Application p. 4
Not altered If not altered - can you tell us why?
How this pet will get along with Will get along fine May need some time to adjust a new dog? Do you anticipate any problems? Other:
Indoors Outdoors Kennel / Run Describe where this pet lives and spends most of its time: Other:
Do you currently have more pets than the ones described Yes No above?
Is there anything else you like us to know about your current pets?
9. Previous Pets
If you have had previous (not current) pets before, please complete the information below. You do not need to list pets that your family owned when you were a child.
If you had no previous pets, please check the I have had no previous pets. appropriate box then move on to the next If you have selected the above, please move on to the next section (Part section. 4).
Pet #1 Previous Pet #1 Information Previous Pet 1 Name:
Breed: Poodle Other breed:
Size/weight: Small (under 15 lbs) Medium (15 -35 lbs) Large (over 35 lbs)
Age at death: Puppy Adult Senior Cause of death?
Approximate date of death?
Pet #2 Previous Pet #2 Information CPR Application p. 5
Previous Pet 2 Name:
Breed: Poodle Other breed:
Size/weight: Small (under 15 lbs) Medium (15 -35 lbs) Large (over 35 lbs)
Age at death: Puppy Adult Senior Cause of death?
Approximate date of death?
Pet #3 Previous Pet #3 Information Previous Pet 3 Name:
Breed: Poodle Other breed:
Size/weight: Small (under 15 lbs) Medium (15 -35 lbs) Large (over 35 lbs)
Age at death: Puppy Adult Senior Cause of death?
Approximate date of death?
Do you have additional previous pets that are not listed above? Yes No
Part 4. You, Your Home and Family
No Have any of your pets had special needs? Yes - please describe:
What do you feed your current dog(s)?
Myself Spouse Children For whom are you adopting this dog? Other:
If you are adopting this dog for another No person, have you told them? If yes, please describe their reaction: CPR Application p. 6
How familiar are you with a poodle's Very, I've had poodles before Somewhat grooming requirements (time and cost)? Not very I'm not adopting a poodle Please provide the name and phone number of your groomer: A dog may live for 10 - 18 years, or even longer. Are you committed to caring for it Yes No Maybe / Not sure that long?
Myself Who will be the dog's primary caretaker? Someone else:
Please describe your typical day:
Have you ever volunteered with or applied to adopt from a rescue group? Yes No Some rescue dogs may have behavioral problems due to their previous situations. Yes Are you willing to attend obedience and No other types of classes in order to train the dog? Maybe / Not sure
Please describe your family and lifestyle. Include the ages of all children living in or visiting in the home on a regular basis:
Does everyone in your family want to adopt a dog? Yes No Maybe / Not sure
Single family home Apartment Please describe your home Condo / Townhouse Other:
Not applicable. We own our home
If renting, please provide your landlord's name, phone number and/or email address: If renting, does your lease allow pets?
CPR Application p. 7
Do you have a physically fenced yard? No physical fence Chain link Please note: We do not adopt Standard Poodles to homes that do not have physical Vinyl privacy Wood privacy fences (underground or electronic fences Picket or other wood Underground or electronic are not considered sufficient). Other type of fence:
If you have a fenced yard, please describe height and the approximate size:
Height: Less than 3 feet 3 feet 4 feet 6 feet More than 6 feet
Approximate size (i.e. 100x60 feet):
Do you have a pool? No Yes
If you have a pool, is it enclosed in a separate fenced area? No Yes
Please describe the lifestyle you envision for your new dog:
0 to 3 4 to 7 8 to 12 How many hours per day will the dog be home alone each day? Other:
Crate Inside house Outside Where will the dog stay when he/she is home alone? Other: If you work, can you come home for or arrange for a mid-day potty break? Yes No Maybe / Sometimes What arrangements will be made for the dog when you travel?
How do you expect the dog to behave in your home? In public?
Companion Agility competitor Therapy dog What are your goals and expectations for the new dog? Other: CPR Application p. 8
Please describe how you would teach your dog a new behavior or trick:
Couldn't be housetrained Aggression Under what circumstances would you return a dog to Carolina Poodle Rescue? Move to a new home or city If I die or become disabled
Other:
Part 5. References and Such
Our contract with adopters specifies that the dog will be returned to Carolina Poodle Rescue if you can't take care of it for any reason. We will ask that you maintain the dog in your home until a new Yes No placement can be found. Will you agree to this requirement? A home inspection visit is part of our screening process. Are you willing to have a Carolina Poodle Rescue Yes No volunteer visit in your home? Are you willing to travel to Dreamweaver Farms in Pacolet SC (about 30 min east of Spartanburg) Yes No to meet your new dog?
Yes Are you ready to adopt your new pet now? If not, when do you want to bring your new pet home?
Carolina Poodle Rescue requires at least two character Reference #1 references. These should NOT be family members. Name: They should be pet owners themselves and should have Phone: some knowledge of how you interact around animals. Email: Please list these references along with phone numbers (include the area codes) and email addresses. Reference #2 Name: Please tell your references that a CPR volunteer will be Phone: contacting them. We cannot process your application if your references do not respond to our calls and/or emails. Email:
If you have current or previous pets, CPR requires a veterinary reference. I have no vet. Veterinarian Please list the name, full address and phone number Name (with area code) of your veterinarian. and Address: CPR Application p. 9
Veterinarian If you have used more than one veterinarian, specify Phone which pet(s) is a client with each specific Number: veterinarian. List all veterinarians involved in the care of each pet and include the approximate date range during which care was provided.
If this dog is not for the applicant, please also provide the name and address of the person on whose behalf you are applying; we must have the name so that the appropriate account can be found.
PLEASE TELL YOUR VET THAT A CPR VOLUNTEER WILL BE CALLING THEM.
Do you have any questions?
Time to call #1: Time to call #2: Please give three good days/times to contact you by phone, and a phone number to use: Time to call #3:
Phone number to contact you: May we have your permission to cross post to other poodle rescue groups? Yes No
Carolina Poodle Rescue Website Adopt-A-Pet How did you learn about Carolina Poodle Rescue Pets911 Petfinder Friend (CPR)? Other:
May we add you to our mailing list? (This will only be used for CPR information, such as our newsletters and Yes No special events. You may unsubscribe at any time.)
Completed By (your name): Email Address: (please type carefully, as this will be how we contact you!) Date: CPR Application p. 10
Please save this document, and email it to [email protected]
Please read the information below. It describes our screening process and tells what you can expect as we review your application.
Carolina Poodle Rescue is as much sanctuary as shelter, and our animals are only placed when we are as sure as we can be that the new home is the last and permanent home for this pet. In addition, our research shows that animals and homes that are thoroughly screened and matched make better permanent relationships between the pet and the family.
Carolina Poodle Rescue is staffed by experienced volunteers who are also dog owners. Our dogs are maintained at Dreamweaver Farm (our main location) or at foster homes until a suitable permanent home can be found. We know our dogs very well. Unlike most shelters, we have an excellent success rate with our adoptions. Fewer than two percent of our placements are returned due to incompatibility. This is a tribute to our diligence in screening potential homes as well as the skill of our volunteers. Though you may apply for a particular dog, please allow our adoption counselors to advise and guide you in the selection of your next companion.
Our adoption process is extensive. Your answers will be reviewed and your references will be contacted. Should we not receive a positive report, you will be contacted by email and given the opportunity to correct the information we have been given. Once references are approved, you will be contacted by phone for an extensive interview. If that step is approved, you will be visited in your home by a CPR rescue volunteer. In addition, we retain the right to conduct follow up visits at one week, one month, six months and annually.
We retain the right to refuse any adoption.
CPR charges adoption fees that vary with each dog. Adoption fees are posted along with the description of each animal. Rescue and rehabilitation efforts are funded solely through adoption fees and donations. We receive no public funds. We do not euthanize. Once an animal has been accepted into CPR, it will be cared for throughout its natural life and it is always welcome to return here. In fact, our contract requires that you return the dog to CPR if you can no longer care for him or her, no matter what the reason. Thank you for applying to adopt a rescue dog. We look forward to working with you. You will hear from us within 24 hours of submitting your application. If you do not receive an email within 24 hours, please email us at [email protected] to check on the status of your application.
Carolina Poodle Rescue Pacolet, South Carolina
www.carolinapoodlerescue.org Email: [email protected]
(Application updated March 2011)