Crossing Paths at Yardley -  CROSSING PATHS ANIMAL RESCUE
CROSSING PATHS ADOPTION APPLICATION
You must meet the following criteria before your application will be considered:
·Be 21 years of age or older.
·Have the consent of the property owner and members of your household to adopt a dog.
·Have time and money necessary to provide medical treatment, proper care, and training for the dog.
·Accurately complete this application. Incomplete applications will not be considered.
Name of Dog:
Your Name:
Age:
Address (street, city, state, zip):
Email:
Phone(s):
Length of time at this address:
Type of residence (house, apt, condo):
Do you own, rent or live with relatives/friends? If you rent or live with relatives/friends, provide name and phone number of landlord/homeowner:
We do not require a fence, but if you have one, describe (type, height):
Do you have a pool and, if so, is there a security fence around it?
Adults in your household over 21 - name, age, and relationship to you:
Children in your household - name, age, and relationship to you:
Have you owned a dog before? If so, provide a brief history. If deceased, provide name and date of death:
Provide number, kind, and age of pets currently living in your home. Do they get along with dogs?
Have you ever surrendered a dog to a shelter? Explain. Under what circumstance would you surrender a dog?
The estimated annual cost of owning a dog is between $800-$1000. Would this expense present a problem?
How many hours will your dog be alone during the day and where will he/she be kept while alone?
What kind of exercise will the dog get?
Who will be the main caregiver for the dog?
Have you made provisions for your dog if something should happen to you which would render you unable to care for the dog? Explain.
Provide 2 personal references (non-family), include name, email address, and relationship to you:
If you currently have pets, or if your pet died within the past year, provide the name and phone number of the veterinarian(s) that you use(d):
By submission of this application, I am certifying that I am at least 21 years of age and intend to be the legaL owner and the person responsible for the care and well-being of any dog that I may be approved to adopt from Crossing Paths. I authorize the release of veterinary records for any and all animals I currently own or have owned in the past. I certify that the information contained in this application is true and that false information could lead to the removal of the dog from my possession.
Signature:
Date:
 
 
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