Lap Dog Rescue of New Mexico, Inc
P.O. Box 1316
Tijeras, NM 87059
Adoption Application for (dog's name or breed type):
Please read this Application, fill in the blanks, sign, and return it to us at the address or e-mail above. The information you provide on this Application and during our interview will help us find a good match for you.
Address City State Zip
Home Phone Occupation Hours
Cell/Work Phone E-mail Address
Over 21 years of age?
Previous LDRNM Adopter?
(If you are a previous LDRNM adopter, please complete only this section and any other areas that may have changed.)
Please list three personal references and their relationship to you:
1) Name Relationship
Address Phone
2) Name Relationship
Address Phone
Who is your veterinarian?
Name Phone
Please describe the kind of dog you are interested in adopting:
Age Sex
Reason for sex preference?
Breed/mix Size Color
Why do you want a dog?
Can you commit to care for the dog for its whole life, which could span up to 20 years?
Why do you like the breed/mix you are interested in?
Have you owned this breed/mix before?
Please check all of your reasons for wanting to adopt this dog: Watch Dog Companion Breeding
Hunting Family Pet Guard Dog for Business Child’s pet Companion for other pet
Please provide the following information about your current pets (if any), your children (if any) and your home:
Your current dogs:
How many dogs do you now own? Breed/Mix
If none, have you owned any dogs in the past 10 years?
What happened to them?
Were they: purchased from a breeder or pet store? Inherited? Strays? Adopted from a shelter or rescue organization?
Do any existing dogs have any health, behavioral or dominance problems?
If yes, please describe:
Do they get along well with other dogs?
Have they been spayed/neutered? Are their vaccinations up-to-date?
Have you had a dog or cat with an infectious disease, or one who has come into contact with another infected animal, within the last six months?
Other Animals:
Do you have other animals? How many?
What kind of animals?
Children/grand children living in or frequently visiting the home:
Do you have children (temporarily or permantly) in your home? How many? Ages
Have they had or been around animals?
Your home:
Number of Adults Do you OwnRent?
If you rent, do you have written permission from your landlord to have a dog?
Landlord name Landlord phone number
Is your home: an apartment town home single home mobile home other
Do you have a fenced yard? Height of fence: Type of fence
Are there community restrictions on the number, size or breeds of dogs?
If the answer is yes, please explain.
How will your new dog spend its days? (check everything that applies)
Indoors Crated Basement Garage Porch Confined to a room Fenced Yard
Loose Unfenced Tied outside Dog House Kennel Run
How will your new dog spend its nights? (check everything that applies)
Indoors Your bedroom Crated Basement Garage Porch Confined to a room
Fenced Yard Loose Unfenced Tied outside Dog House Kennel Run
Who will be responsible for the care of the animal?
Do all members of your family know that you plan to adopt an animal?
What would you do with your animal should you have to move from your present home?
What do you do with your animal when you go on vacation?
Do any members of your household have any allergies that may be affected by an animal in the home?
What training methods will you use in order to handle potential problems like crying, barking, chewing, digging, etc.?
Sterilization. Mandatory with exceptions only made due to age or health and supported by a statement by a licensed veterinarian.
Home Visit: All adoptions require an application and a home visit by appointment. References will also be checked as necessary. An adoption fee ranging from $175 to $300 will be required at the time of completion of the Adoption Agreement. LDRNM cannot be held liable for any hazard or damages a new dog may present to known or unknown adults, children, any other animals or property. Any health issues that might arise as a result of the care provided after adoption will be the financial responsibility of the potential Adopter. By completing this application you are under no obligation to adopt a dog from LDRNM.
Application Information. All of the information I/we provided on this application is true and correct. If any of the information changes, I/we will advise you promptly.
Signature Date
Signature Date
Lap Dog Rescue Of New Mexico, Inc.
For Lap Dog Rescue use only:
Approved Yes No