Adoption Form – Rose's Wish

Skip to content

Home
Success Stories
Contact Us
Adoption Form
Foster Application
Pups Seeking Forever Home

Please enable JavaScript in your browser to complete this form.

Name *

First

Last

Name of Pet I'm Interested in Adopting *

Email *

Phone *

Are you at least 18 years old? *

Yes
No

Do all of the adults living in the house know about the pet and agree that it can live there? *

Yes
No

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Do you have valid identification with your current address? *

Yes
No

Do you own or rent? *

Own
Rent

If renting, are you able to provide the landowners name and telephone number? *

Yes
No
N/A

If renting/leasing, are there pet restrictions? *

Yes
No
N/A

Does anyone in the household have allergies to dogs? *

Yes
No

How many people are in your household? *

Please list ages

Have you ever adopted a pet from a rescue/facility before? *

Yes
No

Have you ever been refused adoption of a pet from any shelter/rescue? *

Yes
No

What will the pet's role be in the family? *

Companion
Gift for child or someone else
Watchdog
Companion for another pet
Service dog
Other

Check all that apply

Have you had pets within the last 5 years? *

Yes
No

If you move in the future, what will you do with your pets? *

How do you plan to discipline your pet? *

Typically, how many hours a day will the pet be alone in the home without a human ? *

How many days a week? *

Where will the pet be kept when alone? *

Where will your pet be kept during the day and at night? *

How many times per day do you plan on taking the animal outside? *

Do you have a fenced in yard? *

Yes
No

Type and Height of Fence

For outdoor pets, what type of shelter will be provided? *

Do you plan to use a tether, chain, or rope as a means of confining? *

Yes
No

Do you require the pet to be housebroken or are you willing to train? *

Read Carefully and Check Boxes to confirm that you understand and agree to each section: *

I certify that the above information is true and that I recognize that any misrepresentation of facts may result in my losing the privilege of adopting or keeping an adopted pet.
If for any reason, this animal does not work out in my home, I will return the animal to Rose’s Wish. I will not give the animal to anyone, turn the animal into a shelter, or harm the animal in any way. I realize my responsibility is to contact Rose’s Wish with any problems immediately.
I understand that the first three weeks that the pet is in my care is a trial period.
Rose’s Wish reserves the right to refuse any adoption.
I authorize investigation of all statements in this application.
Whereas the adopting person agrees that he/she shall become the responsible owner of the pet, and release and hold harmless Rose’s Wish, its representatives and employees from any and all claims, risk, financial responsibilities related to or surrounding the animal’s behavior, actions, training and care. The new owner accepts full responsibility and risk in adopting and owning this pet.

By Typing my Name Below I agree to all checked boxes.

Scroll to Top