Download Physical Form Please download a copy of the physical form as well, and view the last page for next steps! Representative Use Only: Today's Date MM DD YYYY Adoption Fee $ Shelter Name/ID Dog's Name Crate number Crate Deposit Amt Crate Return Date MM DD YYYY Paperwork Given Yes No Name First Name Last Name Address Where Pet Will Reside Address 1 Address 2 City State/Province Zip/Postal Code Country Email Drivers License Your Veterinarian’s Name and Number Which Training Alliance Movement representative assisted you Would anyone else be the owner of this dog Yes No If yes, name and reason Do you rent or own Rent Own Do You Live In A: House Apartment Condo/Townhome If you rent, does your landlord know about this adoption? Yes No May we contact your landlord? Yes No Does your Lease Agreement prohibit owning a pet, have breed specific requirements or weight requirements? Yes No Name And Phone Of Landlord/Property Manager How many adults are in your household? How many children are in your household? List current pets and where they live (inside/outside) Are these pets spayed/neutered and up to date on vaccines, heartworm preventative and flea medications? Yes No If no, why not? Are you familiar with monthly flea prevention and monthly heartworm preventative? Yes No Does your house have a secured fenced in yard? Yes No Height of fence? Type of fence Chainlink Wooden Vinyl Is anyone in your home allergic to pets? Yes No If yes, explain Is an adult home during the day? Yes No If not, how long will the dog be alone each day? Have you ever surrendered a pet to a shelter? Yes No If yes, explain Has any pet in your household ever run away, been poisoned, or hit by a car in the past? Yes No If yes, explain Please Read Carefully I acknowledge receipt of and full responsibility for the pet named above. I agree to keep him/her in my possession and give proper food, water, healthcare, shelter and loving treatment. I agree to contact the rescue representative if I am unable to keep this pet, keeping in mind these representatives are volunteers and have families/full-time jobs and will get back to me within 8 hours. I agree if I cannot keep my new pet, I will reach out to a TAM representative to assist with next steps which may include transporting the dog to the original shelter myself. FOLLOW-UP: I AGREE to follow up with Michelle and the TAM representative by 7:00 pm the day of the adoption WITH A PICTURE OR VIDEO of the dog in my home (see “Take Home Page” for contacts). MOBILE ADOPTIONS: This pet is from a mobile adoption, from a shelter such as Putnam County Animal Control. Training Alliance Movement (TAM) assists with transporting the animals to the adoption site and will provide support as the dog is transitioning into your home. We can only assist with taking these pets back if we have an available space on the transport van. If you decide not to keep this pet and cannot wait until the following adoption event when we may be able to assist with transportation, you will be responsible for returning the pet yourself to the appropriate shelter during normal business hours. **Putnam shelter is closed Saturdays and Sundays; however, we can help arrange a time if needed during weekend hours once notified. We DO NOT have a place of business to house a dog if you are unable to keep him/her. If you can continue fostering the pet until the next adoption event, we will work with you to have him/her dropped off at the designated adoption location at 11:00 a.m. and we will help the pet get back to the shelter if not adopted at the event. Please contact us first and we will assist you. By Submitting this form you agree to the following: 1. If for any reason I am unable to keep this dog, I will notify a TAM representative for assistance (returning dog to shelter, holding until next adoption event, finding a foster, etc.). 2. I will treat this dog as a family pet, with affection, kindness and not subject this dog to abuse or cruelty at any time. 3. I will provide proper food, shelter, fresh water, adequate companionship at all times and to keep this dog on leash when this dog is not in a secured area on adopter’s property. Proper shelter means this dog is to be an indoor dog, not to be left outside for long periods. Under no circumstances is this dog to be a “yard dog”. 4. I will provide regular veterinary care, including annual vaccinations, parasite checks, and monthly heartworm and flea prevention. 5. I agree to not leave this pet alone with children at any time as the pet’s history is unknown. 6. I will be responsible for any medical care for this pet once I bring this dog to my home. I will reach out to a TAM representative if I need assistance or unable to medically care for this dog prior to returning him/her to the shelter. 7. I acknowledge receipt of the adoption paperwork available at the adoption event, which includes any previous vet/medical attention provided to the dog before the event. This will be given to my dog’s vet within a month to ensure proper prevention is established. 8. I will register the microchip (if provided) in my name and add my contact information. I will also ensure my new dog will have ID tags with my info in case he/she gets lost. 9. I will reach out to a TAM representative for assistance with the dog’s conduct prior to returning the dog to the shelter. 10. I AGREE TO HOLD TRAINING ALLIANCE MOVEMENT ANIMAL RESCUE (TAM) AND ITS REPRESENTATIVES FREE FROM ALL LIABILITY ARISING FROM THIS PET’S CONDUCT. Adoption fee If paying by check, please allow two weeks for processing due to 501c3 procedures $ Donation to help other homeless pets $ Total amount received $ Cash/Check # Received by (representative) Date MM DD YYYY This amount is non-refundable. If you decide not to keep this pet at any time in the future, your adoption fee is considered a donation towards the non-profit as we strive to find wonderful homes for dogs from overcrowded shelters. You may request a copy of this contract for future reference or take a picture with your smart phone. My signature below indicates my complete understanding and willingness to comply with everything in this contract. As of this date, the adoption of this pet is considered final. Electronic Signature (First and Last) Date MM DD YYYY Thank you!