Worth Every Penny
My pets are not material possessions, but wonderful gifts entrusted to me ……
Why are we committed to saving the lives of animals, placing them in loving homes, and caring for them while awaiting adoption? Because we feel every animal deserves a warm place to call home, and
for once in there lives
to know what it feels like to be truly loved!!!!
Most of our dogs have had a very rough start and need a kind and loving home to show them just how wonderful being a DOG can be, and that not all HUMANS
treat animals as disposable possessions!!!
Hannah Kolzow
630-890-9262
Dog Adoption Application
Caring for an animal is a serious responsibility requiring commitment, morally and financially. We reserve the right to place animals based upon the suitability of the particular circumstance for that animal.
Please answer the following questions as completely as possible. You may write on the back of the application if necessary. If a question does not apply, please write “N/A”.
Date_____________
Name__________________________ Spouse/Sig other/roommate______________________
Veterinarian(s) name and telephone__________________________________________________
Children, name and ages __________________________________________________________
Address ___________________________________________________________________
Please indicate type of home (house, townhouse, condo, and apartment) ________________________
Home number ________________________ Work number ____________________________
Cell or pager number ____________________ E-mail address ____________________________
Do you own or rent your home? ____________________________________________________
If you rent, can you provide a rental agreement that allows for dogs? ________________________
Have all members of the household agreed to adopt a dog? ________________________________
Do you currently own a dog(s) or other pets? ___________________________________________
If you answered yes, what breed, age, and sex is the dog(s) or other pets? _____________________
______________________________________________________________________________
Have you owned a dog(s) or other pets in the past? ______________________________________
If you answered yes, what happened to the dog(s) or other pets? ____________________________
______________________________________________________________________________
When you leave the home or while you are sleeping, where will the dog be kept (backyard, in a dog house, in the garage, anywhere inside the house, etc.)? ____________________________________
Do you a fenced and gated backyard? ________________________________________________
If you answered yes, what material is the fence (iron, chain link, wood, etc.)? ___________________
Will you provide consistent veterinary care for the dog, including but not limited to, vaccinations, annual examinations, dental, and emergency care? _______________________________________
______________________________________________________________________________
Are you in a financial position to provide veterinary care costing $500.00 or more, if necessary? ______________________________________________________________________________
Where will the dog stay when you travel for business or pleasure? ___________________________
Provide any comments you wish: ____________________________________________________
______________________________________________________________________________
I have completed the above information to the best of my ability. I declare all the information is true. I agree that although all dogs are medically examined and treated before placement, and every effort is made to match appropriate dog with each home, no guarantees are expressed or implied as to personality or medical soundness of the dog. I agree to accept the dog “as is” and understand that the adoption donation is non-refundable. If for any reason during the life of the dog you are unable to keep him/her reguardless of the reason, Worth Every Penny requires them to be brought back to us, NO QUESTIONS ASKED, and we will help find a suitable home!!!
Adopter signature ____________________________ Date __________________________
Please do not buy your puppy from a pet shop or broker as nearly ALL these
puppies come from a Puppy Mill where adults live in cages every minute of their
lives, are treated only as breeding machines, are not tested for any inherited genetic
defects, and neither adults or puppies are properly socialized. Buy only from reputable
breeders who are breeding to improve the health and quality of their dogs and
who care about the welfare of the dog.
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