On-line Application to the right is the best way to get your application to us.

Copy and Paste Robbi's Application and attach to an email, fill it out, then email to sarahs2ndchance@yahoo.com or use the APPLY button for the online application.

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On-Line Application

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Robbi's QR code
for adoption application

Scan the code with your cell phone

Robbi's Adoption Application 

 

Our goal is to provide loving, forever homes for wonderful dogs in order to ensure their well being and lasting happiness!!  

 

 

**  PLEASE COMPLETE ALL INFORMATION **  

 

 

NAME OF DOG:  

 

Are you over 18 years of age?     

 

Date of Birth:  

 

*** PERSONAL INFORMATION *** 

  

Name:  

Spouse or Significant other's name:  

Street Address:  

City:  

State:  

Zip Code: 

 

Your Age: 

 

Home Phone:       

Work Phone:  

Cell Phone:  

Best time to call:    

Email Address:  

Occupation:  

Spouse or Significant Other's Occupation:  

How many adults are in your household?  

Do you have any children?  

If Yes, Names and Ages: 

*** HOUSEHOLD INFORMATION ***

Do you live in a house, apartment, trailer, mobile home, other?  

Do you rent?  

Do you own?

If you rent do you have the landlord’s permission to keep a dog?  

Landlord’s name:   

Landlord's phone number:  

Are there any restrictions from your landlord or subdivision for having pets?

Such as .. Number of pets, size or weight restrictions, breed restrictions 

Years at current address:  

If less than 1 year - previous address:  

Are all members of your household in agreement with this adoption?

Do you have a fenced yard?  

Do you have any of the following ...  

Underground fence

Outdoor kennel

Dog run

4' chain link, wooden/vinyl fence

5' chain link, wooden/vinyl fence

6' chain link, wooden/vinyl fence

7' chain link, wooden/vinyl fence

8' chain link, wooden/vinyl fence

Partial fenced in yard 

How will you handle daily toilet duties?  

 

How many hours per day will the dog be left alone?

 

Where will the dog be kept when you are out of the house?  

In house  

Roam free  

Gated room  

Crate  

Basement  

Outdoor kennel  

Dog run  

Tethered outside 

Daytime: 

In house  

Roam free  

Gated room  

Crate  

Basement  

Outdoor kennel  

Dog run  

Tethered outside   

At Night:  

In house  

Roam free  

Gated room  

Crate  

Basement  

Outdoor kennel  

Dog run  

Tethered outside 

Have you owned a dog before?  

If you have children or grandchildren, have they been around dogs?  

Do you have grandchildren that visit often?  

List ages of grandchildren:  

Does anyone in your home have allergies to dogs or have asthma?

 

*** DOG INFORMATION ***

Do you own a dog now?  

How many?   

List all names, sex, breeds and ages of dogs you own now:  

 

  

Is your dog/dogs spayed/neutered? 

If not, reason why?  

Deceased dog(s)? 

List all names, sex, ages, breeds and cause of death:

Have you adopted a dog from a shelter or a rescue group before?  

Have you ever given up a dog/cat?

If yes, what were the circumstances?  

*** CAT INFORMATION ***

Do you own a cat now?  

How many?      

List all names, sex, ages of cats you own now:  

 

  

Is your cat/cats spayed/neutered? 

If not, reason why?  

Deceased cat(s)? 

List all names, sex, ages, and cause of death:

Have you adopted a cat from a shelter or a rescue group before?  

Have you ever given up a dog/cat?

If yes, what were the circumstances? 

 

 

*** VETERINARY INFORMATION ***

It is required that all applicants must have a vet reference check.

Please call your vet and release your records to Robbi Lee Roy

Thank you

May we contact your current vet? 

 

Name of your vet Facility: 

Street Address:  

City:  

State:  

Zip Code:  

 

Veterinary facility phone number:  

Can you provide documentation if asked that your pet(s) previous or current are up to date on all necessary shots and are spayed/neutered? 

 

Will you allow a representative to visit your home by appointment? 

*** NEW DOG INFORMATION *** 

What age group are you looking to adopt?

Puppy (8 weeks to 1 yr old)  

Young (1 yr old to 2 yrs old)    

Adult (2 yrs old to 7 yrs old)  

Senior (over 7 yrs old)  

Any age group  

Are you looking to adopt a ...  

Special Needs dog  

Hypoallergenic dog  

Shorthaired dog  

Longhaired dog

Low shedding

What size dog are you looking to adopt?  

Small (25 lbs or less)  

Medium (26 - 60 lbs)  

Large (61 - 100 lbs)  

X-Large (101 lbs or more lbs)  

Do you understand that the breed of most rescue dogs that we rescue are not fully known?

Do you understand that when we rescue a pregnant mother, the father is not known, and the puppies can be multiple breeds?  

Many of the rescue dogs that we rescue are not fully house trained, are you willing to train and work with them?  

If you are adopting a senior dog, do you understand that they may have accidents in the home?  

Have you ever house-trained a dog or puppy before?  

If the dog has an "accident" in your home, what type of correction do you plan to use?  

Are you aware of crate training?  

Will you be using a crate?

Are you willing to work with the new dog on basic training?  

Do you plan to take an obedience class with your dog?  

Are you aware that a new environment is stressful for your dog, and they may exhibit uncharacteristic behavior's, such as, accidents in the house, being shy, barking, not eating for a few days, having diarrhea, etc?  

A new dog in a new home takes time to adjust to his new surrounding. Are you willing to work with him/her to adjust?  

What length of time will you allow your new dog to adjust to his/her new home?  

Do you understand that a dog can be an 18 year commitment, and can cost $300 - $500 or more per year to care for?  

How did you find out about Robbi Lee Roy Rescue dogs?  

Adoptapet.com  

Petfinder.com  

Facebook  

Friend/family member  

Website  

Is there any other information that might help us place a dog with you?  

Do you agree to contact Robbi Lee Roy if you are no longer able to keep or care for any dog that you adopt?

 

 

* * * DISCLOSURE * * * 

 

ROBBI LEE ROY’S DOGS ARE HOUSE DOGS AND ARE NOT TO BE HOUSED OUTDOORS OR ALLOWED TO ROAM FREE.  ALL PUPPIES NOT SPAYED/NEUTERED MUST BE DONE BY 6 MONTHS OF AGE OR APPROPRIATE DATE GIVEN BY THE NEW VET AND THE NEW OWNERS.  PROOF OF SPAY/NEUTER MUST BE PROVIDED WITHIN 10 DAYS OF THE PROCEDURE.  THIS WILL BE OUTLINED IN THE ADOPTION CONTRACT SHOULD YOU BE ALLOWED TO ADOPT A ROBBI LEE ROY DOG. 

ALL OF THE INFORMATION I HAVE GIVEN IS TRUE AND CORRECT.  I WILL PROVIDE THIS DOG WITH PROPER AND SUFFICIENT FOOD, WATER, SHELTER AND MEDICAL CARE, COMPANIONSHIP AND HUMANE TREATMENT AT ALL TIMES.  I AGREE THAT ROBBI LEE ROY IS IN NO WAY LIABLE OR RESPONSIBLE FOR ANY DAMAGE, ACCIDENT OR INJURY RESULTING IN THE PLACEMENT OF A DOG INTO MY HOUSEHOLD. 

WE RESERVE THE RIGHT TO REFUSE ANY PERSON OR PERSONS FROM FOSTERING OR ADOPTING A DOG THROUGH ROBBI LEE ROY.  COMPLETING AN APPLICATION FOR ADOPTION DOES NOT GUARANTEE OR PROMISE A DOG.  THE BEST POSSIBLE MATCH WILL BE FOUND FOR EACH DOG BASED UPON THEIR CURRENT NEEDS. 

 

 

Applicant Signature: 

 

Date: 

 

Driver’s License Number #1:  

 

State: 

 

PLEASE ATTACH A COPY OF DRIVER’S LICENSE 

 

 

Co-Applicant signature: 

 

Date: 

 

Driver’s License Number #2:  

 

State: 

 

PLEASE ATTACH A COPY OF DRIVER’S LICENSE