Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Daytime Phone

(###)

###

####

Evening Phone

(###)

###

####

Best Time to Call

Hour

Minute

Second

AM PM

How long have you been looking to adopt a dog?  *

Just started

Two months or less

Three months or more

Please describe your household:

Active

Noisy

Quiet

Average

Clinic Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Clinic Phone

(###)

###

####

By providing Urban Tails Animal Rescue with this information, you are allowing us to contact your vet. Please call your vet and ask them to authorize the release of information to Urban Tails Animal Rescue.

I AGREE

Desired sex

Spayed Female

Neutered Male

No preference

Willing to adopt

Outgoing/hyper dog

Dog that needs regular medication

Dog that needs grooming

Shy dog

Dog that needs training

None of these

Do you have experience with or are willing to work through the following with your dog if it were to occur?

Separation anxiety

Leash reactivity

Territorial Behaviour

Excessive barking

Housetraining

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Adoption Agreement *

By sending this electronically, I acknowledge that I have completely read this document and comprehend it fully. I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any URBAN TAILS ANIMAL RESCUE animal adopted by me. I certify that the above information is correct, and I understand that the information will be verified. I understand that by submitting this form electronically, I agree to release and covenant to hold harmless URBAN TAILS ANIMAL RESCUE and its members from any claims, damages, costs, or actions incurred because of the care or actions of the adopted dog. I agree to have URBAN TAILS ANIMAL RESCUE complete reference call checks and conduct a home visit inspection to be able to approve my application. I agree that if I'm unable to care for the dog(s) anymore that I will contact URBAN TAILS ANIMAL RESCUE and allow an appropriate time frame for URBAN TAILS ANIMAL RESCUE to try and find another suitable home for the dog(s). I understand that URBAN TAILS ANIMAL RESCUE is a non-profit organization whose primary goal is animal rescue, finding the best family matches for the dogs in our care and animal welfare advocacy. The adoption fee is; puppies up to 1 year $500, dogs 1 year and older $450, seniors 8+ years $300 (If a dog is adopted under the age of six months and is not altered, the adoption fee is an additional $75 deposit and is refundable upon completion of spay/neuter). *

I AGREE

I DISAGREE