Adoption Application

adoption application - Russell Rescue

  1. Rescue dogs must have containment (fence, kennel); JRTs are rarely suitable for city living.
  2. We do not place terriers in homes where it must remain alone for extended periods of time.
  3. We do not place dogs in homes where there are children under six years of age.
  4. Few rescue dogs are good with cats.
  5. Most terriers in Rescue are young adults; puppies are rarely, if ever, available.
  6. Filling out an adoption application does not guarantee adoption. Jack Russell Terriers have special needs. Not all homes are suitable for placement.
  7. All applicants are thoroughly screened and must meet certain qualifications before being referred for a terrier.
  8. Compatible terriers may not be immediately available; your patience is appreciated.
  9. A donation to Russell Rescue, Inc. is required to adopt a terrier.
  10. Remember, the more conditions you make (i.e., color, coat type, age, sex and body type), the longer it will take to find a suitable terrier to match your environment.
  11. By submitting this adoption application, you are making a formal request to adopt a dog from Russell Rescue, Inc. Please do not fill out this application if you are not serious about working with Russell Rescue, Inc.
  12. If a terrier is matched to your application and placed in your home, you must agree to keep the terrier for at least 3 weeks (to allow time for the terrier and you to acclimate with each other).
  13. We can only place terriers in homes located in the United States.

Adoption Preferences

In this section, please enter your adoption preferences. Filling out an application does not guarantee adoption. Remember, the more conditions you make (i.e., color, coat type, age, sex and body type), the longer it may take to find a suitable terrier to match your environment.
Name of terrier you would like to adopt: (If Known)
Location of terrier you would like to adopt: (If Known)
Do you want to adopt a?  Age Preference
I am willing to consider a suitable dog of a different:

Applicant Information

In this section, please enter information about the person applying to adopt a terrier. Please make sure you correctly select your state as this information is used to route your application to the correct rescue representative.
Applicant Name:
Street Address:
City:
State:   Zip:
Email Address:
Home Phone Number:   Work:
When is the best time to call?
Your Occupation:
When could you take possession of a dog?
How far would you travel to pick up the terrier?   (in hours)

Housing/Landlord Information

Do you own or rent your home? Own   Rent
I (we) live in a:  If "Other":
Do you have your landlord's permission to own a dog? Yes   No
Landlord Name:   Phone:
How long have you lived at this address?   (Years/Months)

Fence/Yard/Kennel Information

Do you have a completely fenced yard suitable for a dog? Yes   No
Do you have a kennel run? Yes   No
Describe fence and/or kennel run (type, height, size):
If no fence/kennel, how will you handle
the dog's exercise/toilet needs?
Do you have a suitable dog crate? Yes   No

Household Information

How many adults in the household?       Children?
Are you planning to have kids within the next 5 years? Yes   No
Age of adults?
Age and gender of children?
Any household members allergic to animals? Yes   No
How many hours a day must terrier be alone?
Are there visitors to your home with which a new dog will have to interact? Yes   No
How would you describe your lifestyle?

Other Animal Information

Do you own any other dogs? Yes   No
If yes, are they Spay/Neutered?
Please list breed, size, and gender of each:
Do you own any cats?    If yes, how many?
Do you own any other animals?   If yes, describe:
How many dogs have you owned in the past 5 years?
If you do not still own the dog(s), what happened to them?

Breed Specific Information

Have you ever owned a Jack Russell before? Yes   No
Why did you choose this breed?
What is the Jack Russell is bred to do (if you know)?
What activities do you plan with this dog?
Where do you intend to keep this dog primarily? Indoors   Outdoors
Where will the dog sleep?

Veterinarian Information

Do you have a regular veterinarian? Yes   No   (If "No", skip this section)
Vet Clinic Name:
Doctor Name:
Street Address:
City:
State:   Zip:
Vet Phone Number:
Date of Last Vet Visit:

Reference/Miscellaneous Information

How did you learn of Russell Rescue, Inc.?
If "Other":
Personal Reference (Name/Relationship/Phone):
Comments:

If you do not receive a notice that tells you the application was submitted,
please Contact Us.

By submitting this application, you are making a FORMAL request to adopt a dog from Russell Rescue, Inc., an all-volunteer, donation-supported organization. Please do not fill out this application if you are not serious about working with Russell Rescue, Inc. You will be contacted if a suitable terrier is matched to your application. Filling out an application does not guarantee a terrier. Not all homes are suitable for placement. Russell Rescue, Inc. has the right to refuse any application.