Name and telephone # of supervisor SPOUSE's name

Name/Address of Company

Name and telephone # of supervisor

PERSONAL REFERENCE: Name, telephone # & how this person knows you and your ability to provide a good home for a dog

How did you find out about this rescue'? (e g vet, shelter, intemet, friend, etc)

ADOPTION PROCESS:

WHEN WE FIND A DOG FOR YOU: When you adopt a dog through us, you will be asked to sign an Adoption Contract and make a donation

CONTRACT: This contract specifies, among other things, that the dog will receive proper specified home and vet medical care, including an annual exam and shots, heartworm preventative, etc , will be licensed and identified, will never be taken to a shelter or given away; will not be used for anything other than a family pet, will live indoors, will not be

chained, you will contact this rescue if you can no longer keep the dog so we can find a new home, and it allows for us to contact you for verification of the dog's welfare There is also a release statement

DONATION/ADOPTION FEE: is a minimum of $100 for a purebred dog This is all used to help defray vet and

operating expenses for the rescue Please realize that dogs need vet care throughout their lives, including yearly exams and boosters, monthly

medications and flea/tick preventative meds, emergency care, etc If you cannot afford ~ $100, can you afford the appropriate vet care, Please consider this before adoptmg anywhere

Are these terms acceptable to you? If so, please indicate by signing below

I certify that I have read the above Adoption Contract information and fee requirement and will execute same promptly upon receipt.

(sign name)

HELP Would you consider volunteering to help RECYCLED RESCUE DOGS?

__NO __YES If YES, in which of the following areas? Circle as many as apply

Once your application is received and approved, your e-mail address will be added to the notification list. You will be

notified by e-mail, regular mail or phone of all dogs available for adoption. You need only call when the dog is of interest to you so that we may further explore the compatibility.

Please be patient and please contact us at foxshadow@www.jackrussellterriers.com if you change your mind or get a dog elsewhere.

Please PRINT (3) pages & return this application to Patti Cranmer 103Church Rd. Medford, NJ 08055