Application to Adopt

If you'd like to adopt one of our available dogs, please fill out this form. REQUIRED items are very important to fill with accurate information. Entering a placeholder like N/A or TBD will be considered incomplete and your application will not be accepted.

Personal Information

Have you adopted from VIP Rescue in the past?(Required)

Yes

No, but adopted from other shelter or rescue group

Name of dog adopted and approximate date (most recent if more than one)

Your FULL LEGAL name (e.g. what is on your government issued ID)(Required)

First name Middle name - not initials Last name

Address(Required)

Street Address

Address Line 2

City(Required)

County(Required)

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County (legacy)

State(Required)

Zipcode(Required)

Note: We do not adopt outside the state of Florida.

Email(Required)

Home Phone(Required)

Mobile Phone

Date of Birth(Required)

Your Occupation(Required)

Do you live with a spouse/partner?(Required)

Yes

Partner's FULL LEGAL name(Required)

First name Middle name - not initials Last name

Partner's Date of Birth(Required)

Partner's Occupation(Required)

Do you have children at home?(Required)

Yes

List children, use + at right side for additional names(Required)

First Name

Last Name

Age

If you are not comfortable disclosing names of minor children, please indicate at least number of children and ages. We need to know size of household and help place the dog with appropriate age groups.

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Number of children in the home (migration data)

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Child 1

First Name Last Name

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Age

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Child 2

First Name Last Name

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Age

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Child 3

First Name Last Name

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Age

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Child 4

First Name Last Name

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Age

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Child 5

First Name Last Name

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Age

Are there other adults in the home, not including spouse/partner above?(Required)

Yes

List other adults, use + at right side for additional names(Required)

First Name

Last Name

Age

Relationship

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Number of other adults in the home, not including spouse/partner above (migration data)

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Adult 1

First Name Last Name

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Age

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Occupation

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Relationship to Adult 1

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Adult 2

First Name Last Name

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Age

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Occupation

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Relationship to Adult 2

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Adult 3

First Name Last Name

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Age

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Occupation

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Relationship to Adult 3

Does anyone in the home have allergies(Required)

Yes

Professional Care - we may contact any of these to verify

Do you have a pet walker(Required)

Yes

Name of pet walker(Required)

Pet walker phone(Required)

Do you have a groomer(Required)

Yes

Name of groomer(Required)

Groomer phone(Required)

Have you ever taken a pet to a shelter?(Required)

Yes

Please explain circumstances of pet taken to shelter(Required)

Do you have an established relationship with a veterinarian for current or previous pets? We WILL contact them to verify. If you do not have one, please select 'No'.(Required)

Yes

Please contact your veterinarian to inform them you intend to adopt and authorize release of your information to VIP Rescue. If you do not authorize in advance, it will likely delay approval of your application.

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APPLICANT NAME (COPY3)

Veterinarian(Required)

First and Last name of doctor, or name of practice/clinic

Veterinarian City(Required)

Veterinarian Phone(Required)

Veterinarian status(Required)

Active with current pets

Not active / previously used in the past

Personal References - we normally contact all references

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APPLICANT NAME (COPY2)

Personal Reference 1 - this person CANNOT be a family member(Required)

First Last

Phone(Required)

Relationship to reference 1(Required)

Confirm this person is:(Required)

NOT a family member.

Personal Reference 2 - this person CANNOT be a family member(Required)

First Last

Phone(Required)

Relationship to reference 2(Required)

Confirm this person is:(Required)

NOT a family member.

Current pets in the home

Do you have dogs now?(Required)

Yes

List current dogs, use + at right side for additional names(Required)

Name

Breed

Age

Weight

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Number of dogs (migration data)

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Dog 1 Name

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Breed

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Age

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Weight

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Dog 2 Name

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Breed

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Age

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Weight

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Additional dogs if 3 or more - name, breed, age, weight

Do you have cats?(Required)

Yes

List cats, use + at right side for additional names(Required)

Name

Age

Weight

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Number of cats (migration data)

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Cat 1 Name

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Age

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Weight

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Cat 2 Name

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Age

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Weight

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Additional cats if 3 or more - name, age, weight

Are all your current pets spayed/neutered ?(Required)

Yes

Have any pets passed away recently?(Required)

Yes

Describe pets who passed away recently - dog/cat/other, name, age:(Required)

Routine Care and Home Environment

Type of Flea Prevention Used On Your Dogs(Required)

Type of Heartworm Prevention Used On Your Dogs(Required)

I Live in a:(Required)

Name of Mobile Home Park(Required)

Park office phone to verify park's rules regarding pets(Required)

Park office contact name to verify park's rules regarding pets(Required)

HOA phone number to verify rules regarding pets(Required)

HOA contact person to verify rules regarding pets(Required)

Tell us about the place where you live. We may check public tax records to verify who owns the property, if Lease/HOA/CCR restrictions exist for pets, etc.(Required)

Your landlord's contact information is required so we can verify your are allowed to have a pet.

Landlord or Owner's Name(Required)

Landlord or Owner's Phone(Required)

What is your relationship to the owner? (live with parents, owned by business or trust, etc.)(Required)

Do You Have a Fenced Yard?(Required)

Height of fence(Required)

Type of fence(Required)

Describe other type of fence(Required)

During an average day, how much total time within a 24 hour period will the dog be left alone?(Required)

When left alone, where will the dog stay? (crated, free to roam the house, etc.)(Required)

Where will the dog sleep?(Required)

About the dog you are seeking

Would you accept a special needs dog?(Required)

Yes

What type of special needs?(Required)

Are you an experienced dog owner / handler?(Required)

Yes

Dog breeds wanted(Required)

Maximum Dog Weight wanted(Required)

Dog age wanted(Required)

If you are applying to adopt a specific dog, please note this in the comment field at the end of the form.

My dog wish list e.g. active/energetic, calm/gentle, good with children, good with other dogs, a playmate, a companion, etc.

How long have you been looking to add a dog to your family?(Required)

What do you expect your average annual expenses will be for your new pet (in dollars)? What items do you include as normal (non-emergency) expenses ?(Required)

Do you have a contingency plan in case you become unable to care for your pet(s) in the future due to extended illness, disability, death, job changes, housing changes? This could be a family member or friend.(Required)

How did you find VIP Rescue?(Required)

Please specify if other(Required)

Other comments // Is there anything else you wish to share as we consider your application?

Application to Adopt

Personal Information

Professional Care - we may contact any of these to verify

Personal References - we normally contact all references

Current pets in the home

Routine Care and Home Environment

About the dog you are seeking

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