Adoption Application

Which dog are you applying for?*

Applicants Name *

First NameLast Name

Email Address*

example@example.com

Phone Number*

Format: (000) 000-0000.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How long have you lived at your current address?

Are you the primary home owner?

YesNoI am a tenant

How many people are there in your household and please provide the ages of any children. *

Landlord's name and number

Have you discussed this decision with everyone in the household?*

Please select which best applies to your home

BalconyFully fenced yardPartially fencedNo Fence

Do you have a pool in your backyard?

YesNo

Does anyone in your household show signs of allergies to dogs?*

YesNoSometimesUnsure

Do you currently own any other pets?*

Dog(s)Cat(s)OtherNo

Please tell us about your pets, both current and previous.

Please list name, type, age, weight, gender, behaviour, neutered/spayed. If you have not owned any pets previously, please describe any experience you have with animals. If none, put N/A.

Please provide your veterinarian's name and phone number.

If you do not have a current vet, please list one you plan to use

How do you plan on exercising your dog?*

Have you ever surrendered a pet you owned to any animal shelter or rehomed one?*

YesNo

If you answered "Yes" to the above question, please provide detail:

How many hours per day would the pet be alone?*

When you are not home, your dog will be (check all that apply):

Will you be crate training your dog?*

Behaviours that you are NOT willing to work with or situations that would cause you to return this animal are:*

Please provide the name of the trainer or organization that you will be taking your dog to for training*

Please explain why you think this dog is the right fit for you/your family*

Consider your lifestyle, expectations of a new pet, training they may require and behavioural needs, as well as your previous experience

If you have to leave town, emergency or planned, where would your pet stay?

How much do you expect to spend annually on your pet?*

Do you currently have applications in elsewhere with other rescues ?*

How long have you been looking for a dog and have you been turned down?*

This is your chance to tell us a little more about you and why you want to adopt from Northern Connection.

Please confirm that you are aware that your adoption fee includes the spay/neuter of your pet at 6 months of age at one of our rescue clinics. Surgeries beyond 6 months outside of our group of vet clinics will be the financial responsibility of the pet owner. *

How did you hear about us?*

By clicking the submit button:

I agree to Northern Connection's adoption process, that I may undergo a video homecheck or a phone interview at the discretion of Northern Connection. I understand Northern Connection's Adoption Coordinator will contact my reference after a successful interview.
I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Northern Connection BY EMAIL before trying to rehome your pet. NCR is a foster based rescue and may not have space at the time to take in an animal at which point you'll be added to a waiting list with no refund.
I agree to indemnify and hold harmless Northern Connection against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
I understand that Northern Connection will disclose any of the pet's health or behavior issues known before adoption is completed.
I verify all of the above information is true and accurate.

Signature*