ADOPTION APPLICATION SUMMARY

OTHER RESIDENTS?

Spouse/partner?*    YES NO

        If yes, please provide spouse/partner's full name:   

Children?* YES NO

        If yes, how many?        Please list ages:

Grandchildren?*   YES NO

        If yes, how many?        Please list ages:

Other household residents?*   YES NO

        If yes, please list names and relationship:

Other visiting young children (under 10 years of age)?*   YES NO

        Please list ages and frequency of visits:  

Your approximate age range:*

18-29
30-55
56-72
73+

Your spouse/partner's approximate age:

18-29
30-55
56-72
73+

Your roommate's approximate age:

18-29
30-55
56-72
73+

Do you live in a/an…?*

APARTMENT
CONDOMINIUM
TOWNHOUSE
MOBILE HOME
HOUSE

Do you rent or own?*

RENT
OWN

Do you have or have daily access to a yard?*   YES NO

Is your yard completely fenced on all four sides?*   YES NO

Fence type and height: 

        How is it secured (examples; locks, latches, etc.)? 

Do you share the yard with another family, unit, or house?   YES NO

Is anyone home during the day?*   YES NO

Approximately how many hours each day will your dog be alone?*

Are you currently employed?*

YES
NO-Retired
NO-Unemployed

 

Employer's name (Applicant):

 

        Position (occupation):

 

        Address:  

 

        Phone number (including area code):

 

        Are you employed...? FULL-TIME   PART-TIME

 

        How many hours/week?

 

Is your spouse/partner currently employed?

YES
NO-Retired
NO-Unemployed

 

Employer's name (spouse/partner):    

 

        Position (occupation):

 

        Address:  

 

        Phone number (including area code):

 

        Is your spouse/roommate employed...? FULL-TIME   PART-TIME

 

        How many hours/week?

 

Is your roommate currently employed?

YES
NO-Retired
NO-Unemployed

            Employer's name (roommate):    

                    Position (occupation):

                    Address:  

                    Phone number (including area code):

                    Is your roommate employed...? FULL-TIME   PART-TIME

                    How many hours/week?

Do you have any pets currently?*   YES NO

Please list all current pets below:

        Dogs (list how many, breed, sex, age, and spay/neuter status of each):

        Please describe the personality of your current dog(s):

        What do you feed your dog(s)?

        Are there situations in which you allow your current dog(s) off-leash?   YES NO

If yes, please explain where and under what circumstances:

        Do you ever use a “tie out” (overhead line, wire cord wrapped in plastic, extended leash, etc.) with your current dog(s)?   YES NO

If yes, please explain where and under what circumstances:

        Cats (list how many, age, and whether or not they are declawed):

        Other Pets (list number and type):

Have you had other pets previously?*   YES NO

        What kind?

DOGS
CATS
OTHER

                If "other," what type(s)?

Have you ever owned a Schnauzer?*   YES NO

If yes, how many; when?

What became of your Schnauzer?

Have you ever owned another breed of dog?*   YES NO

        If so, please list breed(s):

What became of your former pet(s)?

        Died (how; when):

        Accident (explain) (what happened; when):

        Gave away (explain) (why; when):

        Other (explain):

What type of dog would you prefer?

        Gender preference:*   MALE   FEMALE   NO PREFERENCE

        Age range:*  

        Color preference:*

      SALT & PEPPER                                                    BLACK

 

      BLACK & SILVER                                                  NO PREFERENCE

        Ears:* CROPPED   NATURAL   NO PREFERENCE

        Breed:*        PUREBRED SCHNAUZER         SCHNAUZER MIX (NON-SHEDDING)
 

                             SCHNAUZER MIX (ANY)         NO PREFERENCE       

Are you flexible in your preferences for ...?

        Gender?*   YES NO

        Age?*   YES NO

        Color?*   YES NO

        Ears?*   YES NO

        Breed (purebred or mix)?*   YES NO

What type of personality are you looking for (ex: playful, active, quiet, cuddly, agile, mellow, etc.)?*

Do you have any special requirements (ex: housetrained, good with kids/dogs/cats/existing pets, non-shedding, etc.)?*

Are you interested in adopting a specific dog from NJSRN?*   YES NO

        If yes, please give the dog’s name and your reason:

Some of the dogs in our rescue program have special needs. Examples include:

       Minor special needs: arthritis; special diet from the vet required; medication-controlled minor illness

       Major: blind; diabetic requiring insulin injections; epileptic; unsocialized/poor temperament

Would you consider adopting a special needs pet?*   YES NO

Would you consider adopting two Schnauzers together, if they could not be placed separately?*   YES NO

We do not operate a shelter. Our dogs are housed temporarily in foster homes located throughout the northeastern United States. The Schnauzer that may be matched with your family could be several hundred miles from your home. Although NJSRN can usually help with part of the transportation, your nearest rescuer -- a volunteer -- could also live several hundred miles from you. How far are you willing to drive (one way) to adopt a Miniature Schnauzer?

        I do not drive                Up to 25 miles        25-50 miles

        50-75 miles                   Any distance

Are you adopting this dog for yourself or for someone else (such as for a gift)?*

        If not for yourself, please explain.

PLEASE TELL US ABOUT YOUR HOUSEHOLD:

Are ALL members of your household aware of and in agreement with this potential adoption?*   YES NO

        If no, please explain:

Who will have the main responsibility for daily care or training?*

When you go on vacation, who will care for your dog?*

Does anyone in your household have allergies?*   YES NO

        If yes, to what?

PLEASE TELL US ABOUT YOUR HOME:

If you rent, does your landlord/leasing company allow pets?

YES
NO
DON'T KNOW

May we contact your landlord?   YES NO

           Name:

Work Phone (including area code)
Home Phone (including area code)

Do you have a “doggy door?”*   YES NO

Do(es) your current pet(s) have continuous or limited access to the doggy door?*

YES
NO
N/A (no doggy door or no current pets)

If yes, please explain:

Do you plan to move within the next year?*   YES NO

Do you have an in-ground swimming pool?*   YES NO

        If yes, is there a separate fence around it? YES NO

Do you have an aboveground pool or Jacuzzi/spa?*   YES NO

        If yes, is there a cover, ladder, or deck around it? YES NO

YOUR REFERENCES:

Do you have a regular veterinarian?*   YES NO

        If yes, may we contact him/her?   YES NO

                Name:

                Clinic:

                Address:  

                Phone number (including area code):

Have you used an alternate veterinarian or a veterinary specialist?*   YES NO

        If yes, may we contact him/her?   YES NO

                Name:

                Clinic:

                Address:  

                Phone number (including area code):

Personal references (groomer, pet sitter, co-worker, friend, neighbor, etc. No relatives, please.):

Name:*  

        Phone (work) (including area code):

        Phone (home) (including area code):* 

        Relationship:*  

Name:*  

        Phone (work) (including area code):

        Phone (home) (including area code):*  

        Relationship:*  

If you have not included a veterinary reference, please provide a third personal reference (No relatives, please.):

Name:

        Phone (work) (including area code):

        Phone (home) (including area code):

        Relationship:

YOUR ADOPTED SCHNAUZER:

Are you familiar with the temperament of a Schnauzer, its grooming requirements, etc.?*   YES NO

Where will your new dog spend most days? (Please be specific.)*

Where will your new dog spend most nights (crated, dog bed, owner’s bed, etc.)? (Please be specific.) *

How will your new dog get exercise (examples: running in the yard, walks on leash, dog park, etc.)?*

Are there situations in which you will allow your rescued Schnauzer off leash?*   YES NO

        If yes, what are they (in back yard, running in park, etc.)?

Is there ever a time when you will tie your dog outside?*   YES NO

        If yes, what are the circumstances (in back yard, on vacation, inclement weather, etc.)?

        If yes, what type of “tie-out” (overhead line, wire cord wrapped in plastic, extended leash, etc.) would you use?

Do you plan to enroll your rescued Schnauzer in formal obedience training?*   YES NO

Do you agree to keep your adopted Schnauzer as a house pet/inside dog?*   YES NO

WHAT ARE YOU LOOKING FOR IN A MINIATURE SCHNAUZER:

Briefly explain why you would like a Miniature Schnauzer:*

OTHER QUESTIONS:

Have you applied to any other rescue groups?*   YES NO

        If yes, to which one(s)?

Are you financially prepared to provide care and upkeep for a dog at this time (at least $800+/year)?*   YES NO

Have you ever been convicted of animal abuse or animal cruelty?*   YES NO

        If yes, please explain:

NJSRN desperately needs foster homes and transport volunteers. We also need volunteers with skills and experience in other areas. Would you be interested in volunteering?*   YES NO

How did you learn about NJSRN?

Questions/Comments:

VERIFICATION

New Jersey Schnauzer Rescue Network, Inc. (NJSRN) is an incorporated federally registered 501(c)(3) non-profit charitable organization. All donations go toward the care our dogs. Most of our rescues are middle-aged (5-9 years old) and are housetrained. We evaluate most of them in our homes; they live with us and our own dogs while waiting for their new families. All dogs are vet checked, spayed/neutered, vaccinated, wormed, tested for heartworms, groomed, evaluated for temperament, and have basic medical needs (such as dental cleaning) addressed prior to placement. Although we thoroughly evaluate our rescued dogs, we cannot guarantee health or temperament. Adoption fees are donations to NJSRN, not payment for value received, and are primarily based on the age and health of a particular dog and our expenses. The adoption donations for our younger and healthier rescues typically range from $150-$600, while the adoption donations for our senior and special needs dogs are slightly lower. The adoption donation for all puppies is between $450-$600. If a puppy is too young to be altered, an additional refundable spay/neuter deposit of $100 is required. (The spay/neuter deposit will be returned after the adopting family provides veterinary documentation proving that the puppy was altered.) We also have a special “Senior for Seniors” program, in which the adoption donation is waived for a senior citizen adopting a senior Schnauzer. Occasional dogs may have slightly higher than average adoption donations, depending on circumstances and our expenses. Adoption donations are mostly tax-deductible; please check with your tax advisor. Completion of the NJSRN Adoption Application does not guarantee approval. All dogs are subject to prior adoption.

I understand that an adoption donation of $50-$600, determined by NJSRN and based upon the age and specific costs associated with each dog, is required at the time of adoption.

 
(initial here)*

Upon receipt, your application will be reviewed and shared with our members. You will be contacted by a particular dog’s advocate IF your home appears to be a potential match for that dog. We are advocates for the dogs in our care, and must select permanent homes based on their needs. This does not mean that your home is not a good one – it just may not be the right one for that dog.

We maintain a waiting list and your application will remain active on our list for 6-8 months after receipt. Please be patient with our process – we are volunteers stretched to the limit juggling our love and responsibilities for the dogs in our care with our responsibilities to our families, our homes, and our full-time jobs.

I ascertain that I have answered all of the above questions completely and truthfully and -- to the best of my knowledge -- the above information is correct. I give NJSRN permission to contact the references that I have provided.

             (sign here)*

If you would like to print a copy of your application, please print it now. You will not be able to print this application after you submit the form to NJSRN.

(This application prints best with the page orientation set to landscape.)

After you submit the form, you should be directed to a page that confirms submission of your application. If you do not receive this confirmation, please e-mail the webmaster at webmaster@NJSRN.org.