Lifeline Italian Greyhound
Rescue Adoption Application
First Name  
Last Name  
Date of Birth  
Spouse/Partner First Name  
Spouse/Partner Last Name  
Spouse Date of Birth  
Address  
City  
State  
Zip  
Home Phone  
Work Phone  
Cell Phone  
Email  
Occupation  
Spouse's Occupation  
Please tell us why you want to adopt an Italian Greyhound rescue.  
Have you ever had this breed before?   Yes No
If yes, is the dog still residing with you?   Yes No
If not, please explain.  
If you have not had this breed before,
 please explain how you learned about Italian Greyhounds.		  
 

Please list all pets you currently own or have you owned in the past ten years

  Name Type Breed Status Spay/
Neutered		 Vaccinated Length of Ownership (Years)
Pet 1
Pet 2
Pet 3
Pet 4
Pet 5
     
Please list your veterinarian's name for current or past pets (if applicable).  
Please list your veterinarian's phone for current or past pets (if applicable)  
Do we have your permission to contact your veterinarian as a reference?   Yes No
Have you ever given an animal away or surrendered one to a shelter?   Yes No
If yes, please explain.  
Have you ever lost a dog (runaway), or had a pet injured/killed in an accident?   Yes No
If yes please explain:  
Have you ever applied to any other rescue group?   Yes No
If yes, who did you speak with?  
Was your application approved?   Yes No
If no, please explain.  
Which of the following best describes your current living situation?  
Name of Landlord  
Phone of Landlord  
Do you have a private yard?   Yes No
Fenced?   Yes No
Type and height of fence  
Would you consider moving to a location that does not allow pets?   Yes No
Who will be the primary caretaker of your rescue dog?  
Is the dog a gift?   Yes No
for whom?  
Please list all adults in the household and the hours they are typically home.
  Adult Hours Typically Gone From Home
M-F		 Hours Typically Gone From Home
Weekends
1 From
To		 From
To
2 From
To		 From
To
3 From
To		 From
To
4 From
To		 From
To
How many hours a day will your rescue stay alone weekdays?  
How many hours a day will your rescue stay alone weekends?  
Please list all children in the household along with their ages.  
  Child Age
1
2
3
4
Will the children be expected to care for the dog?   Yes No
If so, in what capacity?  
Does anyone in the home have pet related allergies?   Yes No
Would you describe the activity level in your household as:   Low Medium High
Where will your rescue stay during the day?  
Where will your At night?  
     
     
Are you aware there is a period of adjustment for each rescue to its new surroundings, which may include potty accidents, chewing and digging, or other 'undesirable' behaviors?   Yes No
If the dog makes a mistake, please describe what kind of correction you will make  
Have you ever crate trained a dog before?   Yes No
If no, do you object to using a crate or exercise pen, as advised by your rescue rep?"   Yes No
If yes, please explain.  
Are you willing to purchase a crate/pen if you do not have one?   Yes No
If you do not have a fenced yard, are you willing to take the dog out on lead as often as every several hours to relieve itself?   Yes No
Would you like a dog to be indoor housetrained (newspaper, litter box, potty pads)?   Yes No
How will your dog get exercise  
When will your dog get exercise?  
Do you plan on attending classes or any other dog activity with your dog?   Yes No
If yes, what kind?  
Do you have a preference regarding the age of your rescue dog?  
Do you have a preference regarding the sex of your rescue dog?   Male FemaleNo Preference
If yes, please explain:  
Would you consider something other than your stated preference?   Yes No
Would you consider a special needs dog?   Yes No
An older dog?   Yes No
Are you willing/able to be financially responsible for all routine, unexpected and emergency medical care for your rescue dog?   Yes No
Please provide the name and phone number of two non-family individuals who can serve as references:    
  Name Phone
1
2
May we contact your references?   Yes No
May we do a home visit to your home to verify the information you have provided?   Yes No
Do we have your permission to do a follow up visit after adoption?   Yes No
Do you have any additional comments that will assist us in our consideration of placing a dog with you?  
   
Check to agree

INFORMATION AND REQUIREMENTS
You must agree to never let your IG off leash in an unfenced area.
You must agree to keep your Italian Greyhound as a pet in your home as a part of your family. This breed should not be kept outdoors or left outside unattended for any extended period of time.
You must agree to have your rescue dog wear an identification tag at all times.
Adoption fees range from $250 to $350 dollars, depending on the age of the dog.
You must agree to maintain necessary vaccinations recommended by your vet and be responsible for licensing your dog according to regulations in your community.
You must contact your Lifeline IG Rescue Representative and provide notification of any change in contact information from that listed on this application.
You must notify the Lifeline Italian Greyhound Rescue Representative if you cannot keep your rescue dog for any reason. The rescue dog may not be given to a humane shelter, other rescue group, or individual, without the consent of Lifeline Italian Greyhound Rescue.
I understand that Lifeline Italian Greyhound Rescue reserves the right to repossess the rescue dog should any portion of this contract be breached by the adopters or if it is determined the rescue dog is abused or neglected in any way.
IF I QUALIFY AND RECEIVE AN ITALIAN GREYHOUND FROM Lifeline Italian Greyhound RESCUE, I WILL ACCEPT FULL RESPONSIBILITY FOR THIS ITALIAN GREYHOUND.
I CERTIFY  THAT I,   HAVE READ THE ABOVE AND AGREE TO THE CONDITIONS SET FORTH by Lifeline Italian Greyhound Rescue.
I CERTIFY  THAT I,   HAVE READ THE ABOVE AND AGREE TO THE CONDITIONS SET FORTH by Lifeline Italian Greyhound Rescue.

Your application will be forwarded to the local Lifeline Italian Greyhound Rescue Representative and you will be contacted...
Please feel free to get in touch with your local Rescue Rep periodically concerning your pending application.
Lifeline Italian Greyhound Rescue reserves the right to refuse any adoption.


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