Adoption Application - Russell Rescue TN

Before completing this form, be sure to read Russell Rescue of Tennessee’s adoption contract:

Russell Rescue of TN Adoption Contract

Please confirm that all information is correct before submitting as we do not have the man power to confirm personal and vet references. If you or your references haven’t heard from a Russell Rescue volunteer within a few days, please check your spam folder.

Adoption / Foster Application

I am applying to: *

Adopt (permanent home placement)

Foster (guardian until adopter is found)

Are you interested in a specific dog(s) we have available?

Yes

If yes, what is the name of the dog(s) you are interested in? *

First Name *

Last Name *

Address line 1 *

Address line 2

City *

State *

Zip code *

Primary phone number *

Secondary phone number

Email address *

Occupation *

Place of employment

Are you married? *

Yes

If yes, spouses name *

Please list legal names and ages of all adults (18 and over) that live in the household, including yourself.

Please list first names and ages of any children under 18 that live in the household. (put n/a if you have no kids)

Is everyone in the household in agreement with the decision to adopt a dog?

Yes

Do you own or rent your home? *

Own

Rent

If you rent, please attach a copy of your current signed lease.

Maximum file size: 516MB

Do you live in an apartment, house or other? *

Apartment

House

Other

If other, please explain *

Do you have a fenced yard for the dog? *

Yes

If no, are you willing to leash walk the dog? *

Yes

If you do have a fenced yard, please attach some pictures of your fence.

Maximum file size: 516MB

Where will the dog be kept when unsupervised?

Do you have other pets in your home? *

Yes

If yes, how many and what types? *

Are your other pets spayed or neutered? This information will be verified with the veterinarian you have listed below. *

Yes

Not Applicable

Are your other pets up to date on vaccines? This information will be verified with the veterinarian you have listed below. *

Yes

Not Applicable

Are your other pets on heart worm preventatives? This information will be verified with the veterinarian you have listed below. *

Yes

Not Applicable

Are your other pets on flea preventatives? This information will be verified with the veterinarian you have listed below. *

Yes

Not Applicable

Current or most recent veterinarian's name. This information must be provided to proceed with your application process *

Current or most recent veterinarian's phone number. This information must be provided to proceed with your application process *

What are the pet name/s that have been seeing or are currently being seen by this vet? This information must be provided to proceed with your application process *

I give my veterinarian permission to discuss my pet care history with Russell Rescue of TN. *

Yes

Have you ever surrendered a pet to a shelter or a rescue? *

Yes

If yes, please explain when and why you surrendered the pet *

Have you ever re-homed a pet? *

Yes

If yes, please explain why and how you re-homed the pet *

Have you ever had a pet euthanized? *

Yes

If yes, please explain the circumstances *

Do you or anyone in your home have medical conditions that might be affected by having a pet in the home? *

Yes

If yes, please explain *

What are you looking for in a dog?

Please list 3 references. Only 1 reference can be a family member.

Please provide personal email addresses as emails to a business email account could be blocked by the company's Firewall.

If you or your references haven't heard from a Russell Rescue volunteer within a few days, please check your spam folder.

Family member reference 1 name *

Family member reference 1 phone number. This information must be provided to proceed with your application process. *

Family member reference 1 email address. This information must be provided to proceed with your application process. *

Non-family personal reference 2 name *

Non-family personal reference 2 phone number. This information must be provided to proceed with your application process. *

Non-family personal reference 2 email address. This information must be provided to proceed with your application process. *

Non-family personal reference 3 name *

Non-family personal reference 3 phone number. This information must be provided to proceed with your application process. *

Non-family personal reference 3 email address. This information must be provided to proceed with your application process. *

I agree to call my references and veterinarian and let them know I have listed them as a reference and that they will be contacted by a Russell Rescue volunteer by either phone number and/or email address. *

Yes

I agree to the $300 per dog adoption fee. Russell Rescue is a non-profit 501c3. Please do not ask us to reduce our adoption fee. By doing this you are actually asking us to reduce the chances of us saving more lives. Note: If the adoption fee is paid through PayPal, then an $8.00 non-refundable processing fee will be added. *

Yes

I acknowledge that I have read and agree to be bound by the terms of Russell Rescue of Tennessee's adoption contract should my application be accepted. *

Yes

Signature -- SIGN HERE AND THEN CLICK SUBMIT. *

Clear

CAPTCHA

Please confirm that all information is correct before submitting as we do not have the man power to confirm personal and vet references.

If you or your references haven't heard from a Russell Rescue volunteer within a few days, please check your spam folder.

You will be notified via email from a Russell Rescue team member if you are qualified to adopt. This process can take up to 10 days, also please remember to check your email spam folder.

Submission of an application does not guarantee an adoption. Russell Rescue of Tennessee endeavors to find the best homes available for our dogs, and reserves the right to turn down any application for any reason we deem appropriate. All applicants must be over 21 years of age.