Date
Date
Name *
Name
Co-Applicant
Co-Applicant
Address
Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Employers Address
Employers Address
Applicants Work Phone
Applicants Work Phone
Co-Applicant Employer Address
Co-Applicant Employer Address
Co-Applicant work Phone
Co-Applicant work Phone
Do Infants or Toddlers Visit Your Home?
Tell Us About Your Home
Is Your Residence
Do You Live in a
Please enter a number
Please enter a number
Do You Plan to Move?
Is there a yard for your dog?
Is there an enclosed fence?
If you don't have a secure yard for your dog, are you prepared to walk your dog at least three times a day on a secure leash?
Please tell us about the other pets in your life
Have you ever had a dog before?
Please list ALL of the pets in your home now
Date of last vet visit?
Date of last vet visit?
Spayed or Neutered?
Shots current?
Date of last vet visit?
Date of last vet visit?
Spayed or Neutered?
Shots current?
If you have had a pet in your home for the last 10 years, please tell us about them
Did they pass away?
Did you ever give a pet away to a:
Have you ever had a pet that died in a accident or ran away and was never found?
Have you ever sold or given away a pet or your pet's offspring?
Please Provide Information About Your Veterinarian
Vet Phone
Vet Phone
Vet Business Address
Vet Business Address
We'd like to know you better so we can find your perfect match. Do you prefer (check all that apply)
Will you be willing to train your dog or go to training classes with him/her?
How did you hear about the Joshua Fund?
Have you, a member or your close and/or extended family, a friend, or neighbor, ever been accused/arrested/convicted of animal cruelty?
Under what circumstances would you re-home your dog?
Are you willing to wait until The Joshua Fund finds a dog that will be the perfect fit for you and your family? You may apply now so we can check your references and we"ll keep you on file for six months.
Do you understand that the dogs we have usually have no history to go with them? They all come from high kill shelters and often have been surrendered by their owners, picked up as strays or have been abandoned. We try to evaluate their temperament but that is not always a true measure of how a dog will behave when they become a part of your family. Are you willing to to give a dog a chance at a new & loving life, no matter what it takes?
I understand and want to apply
IMPORTANT! Please Include the Following
A photo of the inside of your home's main living area

A photo of the outside of your home showing the front as well as the back

A recent tax receipt for your home (to show ownership)

If you rent, please send us a copy of your lease

You may send these documents by e-mail to angie@joshuafundrescue.org or fax to us at 518-536-9003

Thank You!
Full Name
Full Name
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