DFB Adoption Application Form

Dawgs Fight Back

Adoption Application
Thank you for taking the time to fill out this application. Your information will remain confidential and used only as part of the DFB Adoption Program. Please make sure to email over photos of your home/yard and common areas once you complete this application!
Name of Adopter:
Date of Application

MonthDayYear
Date
Street Address:
City, State, Zip
Home Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
Best Time to Call:
E-mail:
Employer:
Employer Number:

Area CodePhone Number
Family and Housing

Who resides in the home and what is their relationship to you and ages if under 18?

Rows	Name	Relationship To You	Ages if Under 18
1
2
3
4
5

Do you live in a

Other
Do you own or rent?
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?
(By providing this information you are allowing DFB to contact your landlord please inform them of this call so they will speak with us)

If you have a home owners association, please provide documentation that any breed of dogs is allowed. If you own please provide mortgage statement. (office use, provided papers:

ALL applicants MUST email photos to dawgsfightback@gmail.com of common areas inside the home and yard/outdoor areas.
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Do you have a 6-foot fence in good repair with latching and locking gates:
If not, how will the dog get exercise and be able to move and run freely?:
Please Describe Your Household
Does anyone in the family have a known dog allergy?
If yes, who:
Is everyone in an agreement and understand the decision to adopt a dog?
Has all family member met the dog?
Do you and your family have the ability to provide adequate love and attention to a new dog?
Current Pet Information

What are the names, breed, and ages of your other animals, are they up to date on vaccines, are they altered?

Rows	Name	Breed	Age	Up to Date on Vaccinations	Spayed/Neutered
1
2
3
4
5

If not neutered/spayed, why?
Have you ever had to surrender a pet? If so, why?
Have you ever had a pet euthanized? If so, why?
Have you ever lost a pet to an accident, please tell us about it:
How do you discipline your pets and why?
Veterinary Information
Do you have a regular veterinarian ( ) Yes ( ) No
Veterinarian’s Name:
Clinic Name:
Phone Number

Area CodePhone Number
Fax Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Providing DFB with this information you are allowing DFB to call your vet. Please call your vet and ask them to authorize the release of information to DFB
About the Dog you With to Adopt
What is your idea of an ideal dog and why?
Desired Age
Desired Size
Desired Breed
House Broken?
Breeds you would not consider adopting and why?
Desired Sex
Willing to Adopt:
Outgoing/hyper dog
Shy Dog
Dog on Regular Medication
Dog That Needs Training
Dog That Needs Grooming
Special Needs Dog
Where will the dog spend the day? Please describe
Where will the dog spend the night? Please describe.
How many hours each day will your new dog be home alone?
Where will the dog stay?
Who will have primary responsibility of the dog’s daily care?
Who will have financial responsibility for the dog?
Do you agree to keep the dog as an indoor dog?
Do you agree to provide regular heath care by a Licensed Veterinarian
If no, why?
While the dog is outside, how to you plan to keep the dog safe and free to running away or getting hurt?
Do you agree if for any reason you are unable to keep the dog you will surrender the dog back to DFB?
Are you willing to let a representative of DFB visit your home, by appointment to do a home check?
What are the best times to schedule an appointment when everyone will be home:
How did you hear about DFB:
Would you be interested in fostering?
Personal Reference

Please list people who is familiar with both you and your current pets
Name

First NameLast Name
Phone Number

Area CodePhone Number
Years Known
Email
example@example.com
Relationship to you
Name

First NameLast Name
Phone Number

Area CodePhone Number
Years Known
Email
example@example.com
Relationship to you
By submitting my application, all of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian.
Electronic Signature

First NameLast Name
Date

MonthDayYear

My Products

Application Fee$15.00

Adoption application processing fee

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please verify that you are human
Should be Empty:

Dawgs Fight Back

Family and Housing

Current Pet Information

Veterinary Information

About the Dog you With to Adopt

Personal Reference

My Products