SCLRR: Adoption Application Form

Please check out Areas We Serve before you continue with the application process so that you do not fill out this application only to find out we cannot accept it. Please read SCLRR Adoption — Just how it works! to learn about our processes and whether they will coincide with what your family needs.

The answers you give on this application will help us to find the best possible match between you and the Labradors available through SCLRR, Inc if you are approved for adoption. Please include area codes with all phone numbers. Please do not enter fictitious phone numbers to get your application accepted into our system. If your application is not being accepted into our system, you can Contact Us to see if we serve your particular area. One of our representatives should be contacting you shortly after we receive your submission. Give us ten working days before you call us again and be sure to mention that you've sent us the filled out forms. Dogs fostered by SCLRR will incur an adoption charge to cover aggregate costs of caring for the dogs, payable at the time of adoption. Our current adoption fees are $225 for dogs up to age six years, $100 for dogs seven years and older. We reserve the right to refuse an application.

IMPORTANT: You will get an email message after filling out and submitting this form. Please print that message, sign it, and mail it to us along with your check for the $10 nonrefundable application fee. The check should be payable to "SCLRR."

If for some reason you can't use this form, call us at 888-554-ALAB to obtain a hardcopy by mail.

First name:
Last name:
Email address:

At minimum, we need your home phone number. The rest of the telephone numbers are optional. ENTER DIGITS ONLY -- no parentheses, dashes, etc.

Home phone (include area code):	choose one 213 310 323 424 562 626 657 661 (LA) 714 747 805 818 949 - -
Best time to call:
Work phone (include area code):	choose one 213 310 323 424 562 626 657 661 (LA) 714 747 760 (Riverside) 805 818 909 949 - -
Best time to call:
Other phone: choose one Cell Phone Pager Number Voice Mail Second Phone	choose one 213 310 323 424 562 626 657 661 (LA) 714 747 760 (Riverside) 805 818 909 949 - -
Best time to call:
Fax (include area code):	choose one 213 310 323 424 562 626 657 661 (LA) 714 747 760 (Riverside) 805 818 909 949 - -
Cover letter for faxing needed? To whom?:

Home Address:
City:
Zipcode:
Occupation:
Personal Reference (name):
Phone number (include area code):
Veterinarian (name):
Phone number (include area code):

Do you choose one own rent your home? If you rent, please mail in (along with the signed copy of your application and your $10 check) written permission from your Landlord, which states that you may have a dog the size of a Labrador Retriever in your home. We cannot schedule a home check until you have obtained this landlord permission in writing. It is your responsibility to let us know when you have obtained the written permission and are ready to schedule your home check.

Do you live in a	choose one house condo townhome duplex apartment mobile home other
If OTHER, describe:
How long have you lived at this address?
If less than one year, give previous address:
Do you have a fenced yard that fully encloses the yard for a dog?	choose one YES NO
Fence height and type: (Please actually measure: very few fences are actually over 6 feet high)
Do you have a separate kennel run?	choose one YES NO
Kennel height and dimensions:
How many adults in household?
How many children (under 18, living at home)?
If none, are any planned?	choose one YES NO
If present, age and sex of children (use M-5, F-10, etc)?
Does everyone in the household want a new dog?	choose one YES NO
If No, please explain:
How do you plan to handle exercise needs?
Are there other animals or people who regularly visit your home (mother's dog, neighborhood children, relatives, etc):	choose one YES NO
If yes, describe:
Do you own other dogs?	choose one YES NO
Give breed, sex and age of each:
Are they neutered?	NOT APPLICABLE YES NO SOME ARE
If not (all) neutered, why not:
Do you own cats?	choose one YES NO
If yes, how many:
Do you have other pets? Describe:
How many dogs have you owned in the last five years?
What happened to those you don't own now:
Have you owned a Labrador Retriever before?	choose one YES NO
Why did you choose this breed?
List all plans for this dog: (check all that apply)	Pet choose one YES NO Guard/Alarm choose one YES NO Hunting choose one YES NO Therapy choose one YES NO Obed/Agility choose one YES NO Companion to children choose one YES NO Companion for other dog choose one YES NO
Preferred sex?	choose one MALE OR FEMALE MALE ONLY FEMALE ONLY MALE PREFERRED FEMALE PREFERRED
Preferred color?	choose one ANY COLOR YELLOW ONLY YELLOW PREFERRED YELLOW OR BLACK YELLOW OR CHOCOLATE BLACK ONLY BLACK PREFERRED BLACK OR CHOCOLATE CHOCOLATE ONLY CHOCOLATE PREFERRED
What is your age preference?	choose one ANY AGE UNDER 6 MOS UNDER 1 YEAR OVER 1 YEAR BETWEEN 2-4 YEARS UNDER 5 YEARS BETWEEN 5-8 YEARS OVER 8 YEARS
Why do you want a dog of this age?
Where will dog spend the day?	choose one LOOSE INSIDE LOOSE INSIDE and FENCED YARD CRATE GARAGE GARAGE and FENCED YARD FENCED YARD LOOSE OUTSIDE TIED UP OUTSIDE OUTSIDE RUN WITH ME
Where will dog spend the night?	choose one LOOSE INSIDE LOOSE INSIDE and FENCED YARD CRATE GARAGE GARAGE and FENCED YARD FENCED YARD LOOSE OUTSIDE TIED UP OUTSIDE OUTSIDE RUN WITH ME
How many hours per day, on average, will the dog spend alone?	choose one 6-8 HOURS 1-4 HOURS 8 OR MORE HOURS
Where will dog be when you are at home?	choose one WITH ME IN YARD IN GARAGE INSIDE OR OUTSIDE
Do you agree to neuter/spay the dog you get?	Yes No
Do you agree to contact SCLRR if you can no longer keep this dog?	Yes No
Would you be willing to let a representive of SCLRR visit your home by appointment?	Yes No
How did you hear about SCLRR?
Is there anything else you'd like to tell us about yourself? (Just a couple of sentences is fine)
I am at least 18 years of age	Yes No
All of the information I've given above is true and complete.	Yes No
If I adopt from you, this dog will reside in my home as a pet and I will provide it with adequate food, water, shelter, training, affection, and medical care.	Yes No
I understand that Southern California Labrador Retriever Rescue cannot know everything about each dog's temperament, habits, or physical condition. However, I also understand that SCLRR will tell me everything they do know about the dog including observed behavior, and medical treatment while in SCLRR custody.	Yes No
I understand that it's my responsibility to see and evaluate the dog for myself before agreeing to adopt the dog. I also understand that if I choose not to keep a dog I've formally adopted from you, I cannot expect reimbursment for any expenses incurred.	Yes No
I understand that Southern California Labrador Retriever Rescue is not liable nor responsible for any damage, accident, or injury resulting from the placement of the dog into my household.	Yes No

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