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Rescue Application

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We endeavor to make wise and permanent placements for each terrier. Remember, the more conditions you make (i.e., color, coat type, age, sex and body type), the longer it will take! Please be open-minded to the different qualities that each terrier has to offer.

Important Adoption Points

  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 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 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:
If approved, when could you take possession of a dog?
If approved, how far would you be willing to 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":
If you rent, 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 children within the next 5 years? Yes  No
Age of adults?
Age and gender of children?
Note: we do not recommend JRTs to homes with children under 6 years of age.
Are any members of your household
allergic to animals?		 Yes  No
How many hours a day must terrier be alone?
Are there other visitors to your home, human or animal, 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), please describe what happened to it (them).
Please be specific.

Breed Specific Information
Have you ever owned a Jack Russell before? Yes  No
Why did you choose this breed?
Do you know what the Jack Russell is bred to do?
If so, please explain.
What activities do you plan with this dog?

(PC: Use the CNTL key to select multiple)
(Mac: Use the SHIFT key to select multiple)
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)
Your reference can not be a member of your family.
Comments:

Please review your answers carefully before submitting
this application to Russell Rescue, Inc.

PLEASE DO NOT SUBMIT YOUR APPLICATION MORE THAN ONCE.

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.


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  P.O. Box 4324       Lutherville, MD 21094-4324