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Adoption Application - The Short Form
ROSE CITY TERRIER RESCUE INC.
Please note: Our intention is to gather as much detailed information
about you, your life style,
experiences and preferences so that we can better match a Fox
Terrier with you and your family.
There is the option of setting up a time for a phone interview
instead of filling out an application.
Today's Date:
Email Address______________________________
Name:_____________________________ Day Phone:___________________________
(home, cell or work?)
Address__________________________ Eve Phone:___________________________
(home. cell or work?)
City:_______________________State:___________Zip:___________________
In which breed are you interested? Smooth Fox Terrier YES/NO Wire Fox Terrier YES/NO
1. Do you have a sex preference for your Fox Terrier? Male___ Female____ Why?
2. Do you have an age preference (Please give a range in years)? ____ to _____ years old. Why this age range?
Please note: The average Fox Terrier in rescue is from 4 to 7 years young with the occasional dog that is younger or older. Their life expectancy is 13 to 16+ years.
3. Have you ever owned a Fox Terrier before? If yes, which
breed/coat (Wire or Smooth)?
If NO, Why are you looking for a Fox Terrier?
4. If you have dog experience, have you ever done obedience
and/or trick training with your dog(s)?
If Yes, please explain.
5. What breed of dog(s) other than Fox Terriers have you owned previously and what happened to them?
6. Is this dog intended to be an outdoor or indoor dog, what percentage do you see your Fox Terrier spending time indoors and outdoors seasonally?
7. Do all household adults work or is someone home during the day? Full time/part time?
8. How long on average, will your Fox Terrier be left alone daily?
9. Please list the names of all adults (over 18) living in the home that a Fox Terrier will be place in.
10. If all household adults work full time, or any 8 hour days, can you or someone else come home and let the dog outside?
11. Do you have any other pets or livestock? (Please specify the age and gender of any other dogs. If you have other dog(s) are they submissive or dominant type(s) personalities?
12. Does your extended family (not living with you) or friends have dogs that a Fox Terrier will be interacting with on a semi or regular basis? If YES, please briefly describe these dogs; breed, age and temperament.
13. If you have pets in the home now, how often do you feed them, or do you leave food out all the time?
14. Do you have any children (under 18) living in the household?
____ If Yes, please give their ages.
Do you have any children who visit your home on a regular basis
(family, friends, neighborhood, babysitting)? _____
15. Do you have grandchildren living nearby that visit the
household on a regular basis? Yes___ No ___
If Yes, please give their ages.
16. Do the children living in the home, or that visit on a regular basis have dog and/or terrier breed experience?
17. Do you live in a house ___ apartment ___ duplex ___ condo___?
18. Do you own or rent?
19. Do you have a fenced yard? Yes___ No ___
If YES, what type of fencing?
How high is the fence?
20. In Home Check/Visit - We try to visit each home wanting to adopt one of our Fox Terriers. Are you willing to have a member of Rose City Fox Terrier Fanciers Rescue visiting your home?
21. What kind of exercise and training routines would you put in place for your rescued Fox Terrier?
22. For what reason(s) would you give up your dog? Have you or an immediate family member ever had to give a dog to a shelter, humane society, friend, coworker or rescue organization? If YES, please explain why.
23. Expenses of owning a Fox Terrier - Rescue seek to find
adoptive owners that will provide proper food and medical care
for the Fox Terriers.
Most Fox Terriers do better in general with their health and behavior
if fed a premium dog food ($9 - $13 for a 6.5 to 8 lb. bag) that
is not always available at the local pet shop or grocery store,
special trips might be needed. In addition food supplements might
be recommended. Wire Fox Terriers require a trip to the groomer
every 8 to 12 weeks and all dogs will need their nails trimmed
as well either at a Vet, groomer or at home.
Are these within your financial and traveling restrictions to
supply for a Fox Terrier?
24. In your dog experience have you ever dealt with the
following issues?
General Behavioral Issues:
Separation Anxiety? (Excessive barking and/or panic attacks
when people leave a room or house, destructive behavior when left
alone)
If YES, how was this dealt with?
Would Separation Anxiety be a reason you would turn down a Fox
Terrier?
House Breaking?
If YES, how was this dealt with?
Would a fox terrier that needed work with house breaking be a
reason you would turn down a Fox Terrier?
Aggression: growling, snapping & nipping, biting?
If YES, how was this dealt with?
Would any or all of these types of "aggression" be a
reason you would turn down a Fox Terrier?
Dog vs. Dog aggression?
If YES, how was this dealt with? Would this be a reason you would
turn down a Fox Terrier?
Dog vs. Cat aggression?
If YES, how was this dealt with?
Would dog vs. dog aggression be a reason you would turn down a
Fox Terrier?
Dogs that pull hard on the leash?
If YES, how was this dealt with?
Would a fox terrier that didn't walk well on lead be a reason
you would turn down a Fox Terrier?
Digging?
If YES, how was this dealt with?
Would digging be a reason you would turn down a Fox Terrier?
Bolting out open doors (house/car) or Running away?
If YES, how was this dealt with?
Would bolting out open doors or running away be a reason you would
turn down a Fox Terrier?
Allergies ("Hot spots", excessive scratching,
biting, raw spots etc)?
If YES, how was this dealt with?
Would allergies as described here be a reason you would turn down
a Fox Terrier?
NOTES - Is there anything about you, your family or life style you would like to tell us so that we can match the right Fox Terrier to you?
If a Fox Terrier is found for you to adopt, Rose City Fox
Terrier Rescue Inc. will require an adoption donation on a scale
of $100 to $200 or more (plus extra transportation costs if applicable)
to help defray our ongoing costs of doing business, including
veterinary bills and other costs needed to keep Rose City Fox
Terrier Rescue Inc. saving dogs and for education. We are all
VOLUNTEERS and are not paid for our work in Fox Terrier Rescue.
We freely contribute our time, experience, training to Rose city
Fox Terrier Rescue Inc. All Fox Terriers who are adopted will
come with a supply of food and any supplements they need to get
by for about two weeks. Any medications will also be supplied.
If a dog is fosters for a trial period food and supplement will
be provided by RCFTR. Last update to this document was on Feb.
9th 2008