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Application .pdf


Original filename: Application.pdf
Title: Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application
Author: Yuliya Skurska

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Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

Evan Cordes <ecordes@gm.slc.edu>

Korean K9 Rescue Adoption Application
1 message
Google Forms <forms-receipts-noreply@google.com>
To: ecordes@gm.slc.edu

Fri, Mar 30, 2018 at 8:18 AM

Thanks for filling out Korean K9 Rescue Adoption Application
Here's what we got from you:

EDIT RESPONSE

Korean K9 Rescue Adoption Application
RESCUE ADOPTION APPLICATION: PLEASE BRING A PRINTED VERSION WITH YOU TO THE
ADOPTION EVENT. If you do not we will ask you to complete another one. A copy will be emailed to you
after you press submit. It would make the process easier for you and we could put a face to the name!
Please understand we bring over a small number of pups at a time and the demand is very high so there
will be many applicants for any one dog. Please understand that we highly consider applicants that attend
our adoption events and applicants will not hear back unless they have been seriously considered to adopt
through us. Thank you for understanding.

Email address *
ecordes@gm.slc.edu

https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 1 of 9

Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

Full Name *
First and Last Name
Evan Cordes

Age *
Please note that we do not adopt to people under the age of 24. Thank you for understanding.
26

Street Address *
1921 Avenue K

City *
Brooklyn

State *
NY

Zip *
11230
https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 2 of 9

Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

Phone Number *
570-269-7893

Please list all residents of the household, adults and children, their age, and occupation INCLUDING
yourself. *
Example: Joe Smith, 42, Bank Supervisor
Evan Cordes, 26, Engineer; Yuliya Skurska, 26, Educator

Have you ever been convicted of a felony or misdemeanor? *
If yes, please provide details of the conviction.
No

Adoption Profile Image *
Please upload a picture of yourself for application. This will assist in confirming identities during adoption.
Files submitted:
IMG_5365 - Evan Cordes.JPG

Adoption Preferences

Pet Name of Interest: *
Please enter the name of the dog you're interested in—If there is no one specific you can just fill out the
species/breed preference.
Casia

Second Choice: *
The dog you are applying for may already have an application on him/her. Please enter the name of another
dog you might be interested in. If no preference, please default to Breed, or "N/A"
Hani

Please explain how you learned about this breed. *

https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 3 of 9

Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

If you have no knowledge of this breed, please indicate below.
PetFinder App

Why are you interested in adopting a pet at this time? *
We just got married, and we're not quite ready for kids.

What traits are you looking for in a dog? *
If you are not sure of a breed you're looking for, perhaps we can suggest.
friendly, easy to train, ok for a small apartment, impossibly cute

Have you owned a pet in the last 5 years? *
If yes, is the pet still residing with you? If not, please explain why.
no

Do you currently, or have you ever, bred a pet? *
If yes, under what circumstances?
yes, guppies. many years ago. not on purpose.

Have you ever given an animal away or surrendered one to a shelter? *
If yes, please explain.
no

What, if anything, would cause you to give up your rescue dog now or in the future? *
maybe if the dog had a sudden and very dramatic change in personality

Would there ever be an occasion when your dog would be allowed to run/walk off leash? *
If yes, please explain.
yes, if it was in an enclosed area. or in our apartment :)

https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 4 of 9

Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

References

Please provide the name, telephone number, email address and best time to reach (2) non-family
individuals who can serve as references: *
John 718-422-1111 john@ohmspeaker.com Amelia 845-709-3684
amartin1@gm.slc.edu

Please list your Veterinarian’s Name and Phone number for all current and past pets. *
**PLEASE NOTIFY** your vet’s office that they will be called for a reference check and authorize them to
release information about your pets.
don't have one yet, since we dont currently have any pets

Have you ever applied with any other Rescue Organizations? *
Including recent and past. If so, which one? Was your application approved?
no

Housing

In what type of home do you live in? Own or rent? *
If rent, please enter your landlord’s name and phone number. We need written approval from the landlord.
rent a 1 br aprt

Do you frequently have visitors? *
Please specify if you have young children. How would you describe the activity level in your home?
no. no kids yet. not expecting any. very low energy level - we like to cook
and listen to music. A puppy would be just the bundle of joy that our
household needs.

Does anyone in your home have pet-related allergies? *
not that we know of

https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 5 of 9

Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

Are there stairs in your residence? *
If so, about how many? Are you willing to gate them off?
yes, but not inside the apartment

Do you have a pool? *
If yes, do you have plans to fence it in so that your pets may not get into it without supervision?
only in my dreams

Is your yard completely fenced? *
**Please include Height and Materials. ** Can the gate be opened freely from outside?
if you count the air shaft in the middle of the building as a yard, then yes.
enclosed by brick walls approx. 6 stories high

If you do not have a fence, how will you exercise your dog? How often? *
We are looking for a small dog that we are hoping can get most of its
excersize in our house. We will take it for routine walks at least four times a
day.

How much time will the dog spend alone during the day? *
Where will the dog be kept when you are not home? When at home?
I leave late for work and come home late; my wife leaves early for work and
comes home early. So, the dog would be alone usually for only about six
hours each day.

Where will the dog sleep? *
Will you be keeping your rescue or foster dog in a crate and if so, how often?
We have a spot set aside for either a crate or a bed, depending on the
needs of the particular dog.

Animal Care

https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 6 of 9

Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

Are all animals living in your home spayed and/or neutered? *
If no, please explain.
we do not have any animals yet

Are all the animals living in your home currently vaccinated? *
(Rabies & DHPP). If not, please explain.
we do not have any animals yet

Do you use Heartworm Preventative and Flea/Tick control? If so, what Brand/Method? *
If no pet now, will you?
we do not have any animals yet

Are you willing to take your dog to a veterinarian at least once a year for routine physical
exams,vaccines and heartworm checks? *
Yes
No

Are you willing to be financially responsible for all routine, unexpected and emergency medicalcare
for your rescue dog? Are you able to afford back surgery if your rescue dog requires it? Please keep
in mind that back surgeries usually cost in the thousands. *
Yes
No

Do you have a care plan in place for your rescue dog in case of an emergency and you are no longer
able to care for him/her? *
Yes
No

Are you aware that there is a period of adjustment for each rescue dog, to its new surroundings
which may include potty accidents, chewing and digging or other undesirable behaviors? *
Yes
No

https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 7 of 9

Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

If your rescue or foster dog makes a mistake, please describe how you will correct him or her. *
Depends on the nature of the mistake and when i catch it.

Do you plan on attending training classes or other dog activities with your rescue dog? *
If yes, what kind?
probably not. depends on the specific needs of the dog.

What do you plan on feeding your rescue or foster dog? *
Do you feed once a day, twice a day or free feed?
again, it depends on the specific needs of the dog. some combination of dry
food, wet food, and things that i cook specially for the dog. The dog will be
fed twice a day, and only after we eat. never before.

Please include any additional comments that will assist us in our consideration of placing a rescue
dog with you.
I always had a dog growing up. My very best friend was always a dog. I
have experience in taking care of dogs of different sizes and breeds at all
stages in their life, and now that we have a stable, established household
for the first time in our adult lives, I'm ready to pick up where i left off.

Acknowledgement
We, the management of Korean K9 Rescue, do reserve the right to deny adoption of any
animal in our care for any reason, including but not limited to the following:
1. We feel the animal in question is not appropriate for the living situation as stated by the potential
adopter.
2. We feel the owner does not grasp, for whatever reason; language barrier or lack of knowledge
regarding pet care, or lack of understanding of what is involved in the care and adoption of an
animal, that the animal in question would not be a good fit for the adopter.
3. We feel the potential adopter, is incapacitated, due to any and all mind altering substances and may
not make a rational decision with regards to adopting and caring for an animal.
4. We feel that the animal in question would be in mortal danger, be it from neglect or abuse.
5. If a previously adopted animal is returned, we reserve the right to not re‐adopt an animal to the
customer, without explanation.
6. We feel the adopter in question cannot adequately take care of the animal, whether that is
financially or physically.
We feel that we will always act in the best interest of our animals and as such reserve the right to deny
adoptions in any and all situations where we feel the best interest of the animals will not be served. Animal
Adoption is a privilege, not a right and we believe it is our duty to protect and look out for the best interest
of the animals in our care.
ALL DECISIONS OF THE MANAGEMENT ARE FINAL.
https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 8 of 9

Gryphon Mail @ SLC Mail - Korean K9 Rescue Adoption Application

3/31/18, 11'28 AM

By signing below I attest that all information provided in this application is accurate and valid.
By completing and submitting this Adoption Application, and in consideration for Korean K9 Rescue
providing you with the opportunity to apply to adopt out a dog, you agree to release and indemnify and hold
harmless Korean K9 Rescue,
its past, present and future officers, directors, representatives, agents, employees, volunteers, consultants,
affiliates, successors, and assigns from and against any and all liability, claims, suits, actions, judgments,
costs, fees, including reasonable attorney's fees and damages of any kind or nature for any damage, injury
or other harm of any kind or nature to you, any other person or property arising out of and/or in connection
with attending or participating in any adoption or other events held by Korean K9 Rescue.

Electronic Signature *
Please Type your First and Last Name
Evan Cordes

I understand that checking this box constitutes a legal signature confirming that I acknowledge and
agree to the above Terms of Acceptance.
Accept

Date: *
March

30

2018

Create your own Google Form

https://mail.google.com/mail/u/0/?ui=2&ik=0293409871&jsver=iM8e9…&view=pt&search=inbox&th=16276d8c0aed80f6&siml=16276d8c0aed80f6

Page 9 of 9


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