Name *

First Name

Last Name

Where do you live? *

Do you live in a house? Apartment? Condo? Mobile Home? Other?

House

Apartment

Condo

Mobile Home

Other

Do you rent, own, or other the place you live? *

Own

Rent

Other

Will you be moving in the next 6 months to a year?

YES

NO

Do you have a fenced yard where you currently live?

YES

NO

If you have a fenced yard, what type of fence do you have?

Chainlink

Privacy

Other

Would you allow an onsite premise check?

YES

NO

Do you currently have any other pets?

YES

NO

Are the pets that you currently own spayed/neutered?

YES

NO

SOME ARE

Are the pets that you currently own up to date on their shots?

YES

NO

SOME ARE

Reference 1 *

Please list 3 references: preferably not family members

First Name

Last Name

Reference 2 *

First Name

Last Name

Reference 3

First Name

Last Name

Do you currently have a veterinarian? *

YES

NO

Do you currently use a groomer?

YES

NO

Should I decide not to keep a dog that I adopt from Start Over Rover, I will contact Start Over Rover and arrange a time to return the animal when a kennel becomes available. Until that time, I will continue to properly care for and house the animal.

Agree

Disagree

I understand that I am required to have the animal spayed/neutered within 30 days of the adoption date, or at 6 months of age if the animal is not old enough to be altered before it leaves the rescue.

Agree

Disagree

DISCLAIMER: All of the above information I have given is true and complete. I agree to follow all of the rules and procedures of Start Over Rover. I understand that it is my decision whether or not to adopt any particular dog. I will not hold Start Over Rover responsible for any damage, injury, or harm caused directly or indirectly by any dog I may decide to adopt.

Agree

Disagree