Skip Navigation
Russell Refuge
Abby / 5 years old / Female / Rhinebeck, NY / Rescue Terrier
Abby
Female
Chloe / 8 years old / Female / Rhinebeck, NY / Rescue Terrier
Chloe
Female
Jack / 7 years old / Male / Rhinebeck, NY / Rescue Terrier
Jack
Male
Jacoby / 5 years old / Male / Rhinebeck, NY / Rescue Terrier
Jacoby
Male
Jettro / 7 years old / Male / Rhinebeck, NY / Rescue Terrier
Jettro
Male
Max / 8 years old / Male / Rhinebeck, NY / Rescue Terrier
Max
Male
Moose / 9 years old / Male / Rhinebeck, NY / Rescue Terrier
Moose
Male
Nemo / 4 years old / Male / Rhinebeck, NY / Rescue Terrier
Nemo
Male
Scooby / 10 years old / Male / Rhinebeck, NY / Rescue Terrier
Scooby
Male
Sunny / 6 years old / Male / Rhinebeck, NY / Rescue Terrier
Sunny
Male
Toby / 8 years old / Male / Rhinebeck, NY / Rescue Terrier
Toby
Male
Wishbone / 10 years old / Male / Rhinebeck, NY / Rescue Terrier
Wishbone
Male

Apply for Adoption

Rescue Statement of Commitment

Russell Refuge

We reserve the right to refuse any applicant for any reason if we feel the needs of the dog will not be properly met or the adoption is not in the best interest of the dog. Russell Refuge, Inc. is a non-profit 501(c)(3) corporation, therefore the adoption fees are donations to help us continue the work in helping dogs in need. The medical history of the dog is provided to the best of Russell Refuge's ability, as well as shots necessary for adoption.

Adoption Application

Please fill out the following application completely. The adoption process is designed to match appropriate homes with appropriate dogs. While many dogs may be attractive to the eye, we are very careful to understand the lifestyle of each adopter since we understand the individual dogs in our care and not all Jack Russell Terriers are the same.

Russell Refuge does not ship dogs and requires that the applicant come to the Russell Refuge (in Rhinebeck, New York) to meet us and the dog before an adoption will be made.

We have many dogs here at the Refuge that are not pictured. Do not be shy about adding additional comments. It will help us to get to know you better. Our goal is to place terriers in happy, forever homes where the adopting party and dogs are both winners. Thank you for considering a Refuge Jack Russell Terrier.


Applicant Information
In this section, please enter information about yourself.
 
 

(Facebook, Refuge Web Site, Search Engine, Friend, etc)
Age (range) of adults in household?
(check all that apply)







Are there a lot of children in the neighborhood and/or do children frequently visit you?  
Are you planning on having children in the next five years?



(age, sex, breed, temperament, socialization w/other dogs). This question must be answered in full - if you have other animals are they neutered or spayed?

Would you consider a cross?  
Would you consider a dog that has a behavioral problem (for example; separation anxiety or fear) that might be controlled or cured with training/behavior modification?  
Would you consider a dog with a physical problem (for example epilepsy, etc.) that might be controlled or cured with the use of drugs or surgery?  
Would you consider more than one dog?  
Pick the 5 most important descriptions of what you are looking for in this new dog:
Other than dogs, are there other animals in the house?  

Housing/Landlord Information
Do you own or rent your home?  Rent
If you rent, do you have your landlord's permission to have pets?  
 
(busy street, acreage, etc.)
  (Years)
Are there regular visitors to the home with whom the dog will interact?  
Is your neighborhood urban, suburban, rural?    
Do you live in an apartment, condo, mobile home or single family home?


Do you have a fenced yard?  
hours
Are you planning to enroll the dog in obedience/training class?  

Veterinarian Information
Do you have a regular veterinarian?     (If "No", skip this section)
 

Reference Information
In this section, please enter your references. Please note that two references are required.

(Name/Relationship/Phone)

(Name/Relationship/Phone)

Adopter's Statement of Commitment

I agree that all of the information I have given in this adoption form is true and complete. I agree that this dog will reside in my home. I will provide the dog with adequate food, water, shelter, training, affection and medical care and the dog will not be tied out or on a run. I understand that Russell Refuge is not responsible for the accuracy of information received about the temperament, habits or physical condition of the dogs available for adoption. However, all information provided is given in an effort to do the best in knowing a dog prior to adoption.

Real Person Detector
security code
This helps Russell Refuge prevent spam submissions.
Please review your answers carefully before submitting
this application to Russell Refuge

Home  |  Dogs  |  Adopt  |  Donate  |  Contact Us
© 2017    Russell Refuge, Inc.