Adoption Application Please fill out all fields. Those marked with * are required. Your Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell Phone*Email* Your Age*Please enter a number from 1 to 100.Please list the names, ages and relationship to you of every person who lives with you.*For example: Sally, 55, motherPlease list all the animals who CURRENTLY live in or frequently visit your home. List the type (cat, dog, etc.), Breed, Age, Spayed/Neutered, Source and Years Owned:*For example: Fido, Lab mix, 5 years old, neutered, adopted from local shelter, owned for 2 years.Please list all the animals you have owned in the past. List the type (cat, dog, etc.), Name, Breed, Age, Spayed/Neutered, Source, Years Owned, and Reason the animal is no longer with you.*For example: Shadow, Boxer mix, 12 years old, neutered, adopted from local shelter, owned for 10 years, died of cancer.Please list your Veterinarian as your first reference.If you do not currently have a veterinarian, please list an alternative reference and indicate why you do not have a veterinarian.Veterinarian 1 Name* First Last Veterinarian 1 Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Veterinarian 1 Phone 1*Veterinarian 1 Email If this reference is not your veterinarian, please indicate why you do not have a veterinarian.Please list someone not related to you as a second reference.Reference 2 Name* First Last Reference 2 Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference 2 Phone*Reference 2 Secondary PhoneReference 2 Email Reference 2 Relationship to you*Please list someone not related to you as a third reference.Reference 3 Name* First Last Reference 3 Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference 3 Phone*Reference 3 Secondary PhoneReference 3 Email Reference 3 Relationship to you*Your Interest in RidgebacksPlease answer a few questions about your interest in and familiarity with Rhodesian Ridgebacks.Please describe your reasons for choosing the Rhodesian Ridgeback as your preferred breed.*Have you previously owned a Ridgeback? If so, please describe the experience.*Please describe your reasons for choosing to adopt a rescued Ridgeback.*What makes you a good pet owner?*Have you ever bred dogs? If so, please describe the circumstances and breed.*Have you ever shown dogs? If so, please describe the experience and breed.*Please describe any previous dog training you may have done.*Please list any books you may have read about Ridgebacks, dog training, or dogs in general.*Care and TrainingWhere will this Ridgeback sleep?*Do you plan on using a crate? Please explain why or why not.*Please describe the feeding routine you plan to use.*How many hours per day will the Ridgeback be alone?*Please describe how an adopted Ridgeback might be expected to spend its days in your home. If you work, what will your dog do while you're at work?*Please describe how an adopted Ridgeback might expect to be exercised.*Please describe what activities you plan to share with your Ridgeback.*Who will be the primary caregiver of the Ridgeback?*Please describe the activity level of your home.*Are you financially prepared to provide regular veterinary care?*YesNoWill you keep the Ridgeback on heartworm medication year round?*YesNoWhat types of behavior traits would you be willing to work on correcting?*What types of behavior would you NOT be willing to work on correcting?*In your absence, who will care for the Ridgeback?*Do you plan on taking the Ridgeback to obedience classes? Please describe why or why not:*Have you ever given up a dog in your care to a shelter or other rescue group? If so, please describe the circumstances.*Are you willing to care for the Ridgeback for 10 or more years?*YesNoOne of the provisions of our adoption contract is that all dogs will be spayed or neutered prior to placement. Are you in agreement with this policy? Why or why not?*In the event that you were unable to care for your Ridgeback, what provisions would be made for the Ridgeback?*Dog PreferencesHow soon are you looking to adopt?*Gender Preference (all dogs are spayed/neutered prior to adoption):*Male (neutered)Female (spayed)No preferenceWould you accept a ridgeless Ridgeback? Please explain.*Would you accept a mixed-breed Ridgeback? Please explain.*Would you be willing to adopt a Ridgeback with special needs? Please explain.*Where did you hear about us?*I (We, the above-named Applicant(s), hereby agree to release, indemnify, defend and hold Ridgeback Rescue of the United States, its officers, directors, volunteers, and their successors and assigns, harmless from and against any liability, claim, damage, injury, cost, or expense whatsoever relating to the adoption of any dog from Ridgeback Rescue of the United States.*Type your full name.Your state of residence*ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY