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?

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

Do you live in a*

HouseApartmentCondoMobile Home
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?

YesNoN/A
(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.
Upload Files

Browse Files

Cancelof
Do you have a 6-foot fence in good repair with latching and locking gates:*

YesNo
If not, how will the dog get exercise and be able to move and run freely?:
Please Describe Your Household*

ActiveQuietNoisyAverage
Does anyone in the family have a known dog allergy?*

YesNo
If yes, who:
Is everyone in an agreement and understand the decision to adopt a dog?*

YesNo
Has all family member met the dog?*

YesNo
Do you and your family have the ability to provide adequate love and attention to a new dog?*

YesNo
Current Pet Information

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

	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

YesNo
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?*

YesNo
Breeds you would not consider adopting and why?*
Desired Sex*

MaleFemaleNo Preference
Willing to Adopt:
Outgoing/hyper dog*

YesNo
Shy Dog*

YesNo
Dog on Regular Medication*

YesNo
Dog That Needs Training*

YesNo
Dog That Needs Grooming*

YesNo
Special Needs Dog*

YesNo
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?*

YesNo
Do you agree to provide regular heath care by a Licensed Veterinarian*

YesNo
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?*

YesNo
Are you willing to let a representative of DFB visit your home, by appointment to do ahome check?*

YesNo
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?*

YesNoWold like more information
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