INITIAL APPLICATION PLEASE NOTE ALL APPLICANTS MUST BE OVER THE AGE OF 18 Check if you are 18+ Name * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Do you Own or Rent? Rent Own Have you made sure that there is no breed restrictions for your place of residance or on your renter/homeowner insurance? Would you be willing to have a in-home interview by one of our volunteers? Yes No Who lives in your household? If children live in your home please list ages. When do you see yourself moving from your current residance? ONE YEAR UNDER FIVE YEARS OVER FIVE YEARS NEVER What type of fencing do you have around your home? Current animals in your home or on your property. For any dogs please list breed, age, and if neutered/spayed. What services are you interested in? Adoption Fostering When would you like to start next steps? If interested in starting right away put todays date. MM DD YYYY Age of Akita Interested in Any Age Puppy Adult Senior Please list your experiance with dogs. What breeds have you owned? Please explain your experience with the Akita breed. Why are you interested in placing a dog in your home? How much time do you have to spend with the potential adoptee/foster? Would you consider a pet that needs medical needs? Yes No Do you or anyone in your home have a history of animal, spousal, or child abuse? If yes, please explain. * Are you willing to attend obedience classes? This may be a requirement. Yes No Are you willing to use a crate? Or crate train a puppy if needed? Yes No Salvation Akita Rescue has a strict Spay and Neuter policy. All dogs will be altered before being adopted. By Checking This Box You Agree Any Akita Adoptee or Foster will not be allowed off leash aside from home or fenced yard. By Checking This Box You AGREE Akitas require grooming regularly and shed constantly. On top of that they normally will blow coat twice a year. By Checking This Box You AGREE Akitas have a high pray drive. A natural instinct to chase and catch pray. By Checking This Box You Agree If placed with an Akita I will return the dog to Salvation Akita Rescue in the event that I am no longer able to care for him/her. By Checking This Box You AGREE Akitas require quality food. They are subject to bloat and should not exercise directly after a meal. By Checking This Box You AGREE When bringing home an Akita they will require an adjustment period. What do you believe the first week will look like? Any Akita in my care will never be used in dog fighting, animal research, or protection training. By Checking This Box You AGREE Salvation Akita Rescue reserves the right to reject any application they belive to be an inappropriate match for adoption or foster. By Checking This Box You UNDERSTAND Questions or concerns you may have before moving on to interview? Thank you!