Old Fella Burke County Animal Rescue
Application for Adoption

Please Note: We are committed to matching the right dog to the right family so all will have many happy years together. Our adoption process includes the completion of an application, phone interview, veterinary reference, home visit, adoption fee and contract. We reserve the right to refuse any applicant for any reason if we feel the needs of the animal will not be properly met or the adoption is not in the best interest of the dog. Please submit your completed adoption application using the form below.

You can also print out an adoption application and send it to us

BY MAIL to: Old Fella - PO Box 1437, Waynesboro, GA 30830, or

By FAX to: 866-584-7441, or

By EMAIL to: adoptions@oldfella.org

Please be sure to click "submit" at the bottom of this page when finished.

We advise you to also click here to email our adoption coordinator just to let her know that your application was submitted. We have had, on occassion, some to end up in cyberspace.

NOTE: All items marked with an asterisk (*) are REQUIRED:

CONTACT INFORMATION

*Name:	A value is required.
Co-Applicant
*Address:	A value is required.
*City, State, Zip:	A value is required.
*Home Phone:	A value is required.Invalid format.format: (000) 000-0000
Cell Phone:
Work Phone:
*Email Address:	A value is required.Invalid format.

A complete answer to the following questions will enable us to be more familiar with your request and requirements and will help us find the Rescue animal to match your needs and expectations.

GENERAL QUESTIONS

*How did you hear about us?	A value is required.
*What Old Fella animal are you applying for?	A value is required.
*Who is the animal primarily for?	A value is required.

 

INFORMATION ABOUT YOUR HOUSEHOLD

*Please list all the members of your household with their ages & occupations:	A value is required.
*Current Dog(s) - Name, Age, Breed, Gender, Altered, Comfortable with dogs?	A value is required.
*Current Cat(s) – Name, Age, Gender, Altered, Comfortable with dogs?	A value is required.
*Current Other Pet Types - Type, Age, Comfortable with dogs?	A value is required.
If you do not have a dog/cat now, have you ever owned a dog/cat for which you were the primary caretaker?	Please choose YES or No YES NO Please select an item.
If yes, what happened to the animal?
If you do not have small children living in your home, will your Rescue Animal come into regular contact with any children under the age of 10?	Please choose YES or No YES NO
If yes, how often and what ages?
Does anyone in your house have allergies?	Please choose YES or No YES NO
If yes, what kind?
*Do you own or rent your home?	Please choose OWN or RENT OWN RENT Please select an item.
*How long at current residence?	A value is required.
If you rent, has your landlord provided written permission for you to have a dog?	Please choose YES or No YES NO
Please provide your landlord’s name & phone #:
Do you have a fenced yard?	Please choose YES or No YES NO
*If yes, please describe the fence:	A value is required.
If you are adopting a cat do you plan on keeping the cat indoors?

 

INFORMATION ON THE CARE OF YOUR DOG

Who will care for, train and exercise the Rescue animal?
How will your pet be exercised?
Where will your pet be kept during the day?
Where will your pet be kept at night?
On a typical day, how many hours will your pet be left alone?
Will your dog be allowed in the house?	Please choose YES or No YES NO
Will the dog have free run in the house?	Please choose YES or No YES NO
Are you familiar with crate training?	Please choose YES or No YES NO
Do you plan to use a crate for your new pet?	Please choose YES or No YES NO
Do you plan to keep your dog tied or on a runner outside?	Please choose YES or No YES NO
Will the dog live in the yard?	Please choose YES or No YES NO
Will the dog be allowed to run freely outside of the fenced yard?	Please choose YES or No YES NO
It is strongly recommended that to build a bond with your new dog and establish the ground rules in your family that you enroll in a positive reward-based training class after your dog has settled into your home. Will your dog(s) receive formal obedience training?	Please choose YES or No YES NO
If yes, please identify the animal trainer.
If you ever have to move, what would you do with your pets?
Why do you think you would be a good adopter of a rescue animal?

 

REFERENCES

*Veterinarian's name, address and phone:	A value is required.
Previous vet's name, address and phone,if you had one:
*Personal reference(Not a relative): name, relationship, address and phone	A value is required.
*Personal reference(Not a relative): name, relationship, address and phone	A value is required.

 

MISCELLANEOUS QUESTIONS

May we visit your home prior to approval?	Please choose YES or No YES NO
Are you aware that routine costs of maintaining a dog can be at least $500 a year (for food, shots, checkups, heartworm & flea prevention, grooming, etc.)?	Please choose YES or No YES NO
Have you sold, given away, or surrendered a pet to a shelter, pound or Humane Society?	Please choose YES or No YES NO
If yes, please explain the details.
Do you understand the state and local ordinances concerning licensing?	Please choose YES or No YES NO
Do you understand the state and local ordinances concerning leashing?	Please choose YES or No YES NO
Have you or any member of your family/household been cited for leash law violations or animal cruelty?	Please choose YES or No YES NO
If yes, please explain the details.

 

AGREEMENT

I/We attest that I/we understand that OFBCAR makes no guarantees or statements regarding any dog's age, breed, health, or temperament. While OFBCAR has made every effort to provide accurate history and assessment of all of the animal, OFBCAR is not able to guarantee any animals age, breed, medical status or history, behavior or disposition. I/We hereby release OFBCAR and its employees, directors, members and representatives of any and all possible claims arising from injury or damage caused by any animal adopted by me/us to any person or property or relating to the health or temperament of the animal, including any expenses related thereto. I/We attest that the Terms and Conditions of Adoption as stated in the Adoption Contract have been read in full by me/us and I/we understand that this is part of the adoption process and will be enforced. I/We attest that the information provided on this application is true and accurate to the best of my/our knowledge. I/We attest that we have retained a copy of the Adoption Contract and also understand that completion and submission of this application does not guarantee adoption of a Rescue animal. If filling out the application electronically, your name below substitutes for a signature.
*Type your name here, as your signature:	A value is required.
*Date:	A value is required.Invalid format.
Co-applicant: Type your name here, as your signature:
Date: