Freetown Sanctuary Dog Adoption Application

Freetown Sanctuary

Dog Adoption Application
Freetown Sanctuary is an all-volunteer, non-profit, animal welfare organization dedicated to the rescue and placement of stray, neglected and abused animals.
This questionnaire is designed to help you and us determine if a specific dog is the right one for you and your household.
Name of the dog you are interested in:*
Are you aware that there will be an adoption fee associated with the dog you are applying to adopt? Are you prepared to make the adoption fee payment, in full, prior to finalizing the adoption and taking the dog home?*

YesNo
Applicant Information
Applicant's full name:*
Your age:*
Co-Applicant's full name (if living in same household as Applicant):*
If there is only one applicant please type N/A
Your age:
Street Address:*
City, State, Zip*
Applicant's Phone:*

Area CodePhone Number
Co-Applicant's Phone:

Area CodePhone Number
Applicant's E-mail:*
Co-Applicants E-mail:
Applicant's Employer:*
Co-Applicant's Employer:
1) Character reference and phone number:*
2) Character reference and phone number:*
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:*
Does your landlord allow dogs? Prior to completion of adoption a written consent form will be required from your landlord.*

YesNoN/A
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fully fenced yard?*

YesNo
Height and type of fence*
How many adults are in your household?*
Do you have any of the following?*

Underground fenceKennelDog RunNone
How many children are in your household?*
If children, what are their ages?
Have your children been around animals before?*

YesNoN/A
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages*
How many of these pets are spayed/neutered?*
Where are these animals now?*
If yes, what group?
Have you ever given up a pet?*

YesNo
If yes, what were the circumstances?*
Please provide the name and phone number of your current and/or previous veterinarian or clinic:*
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)*
Are you aware of crate training?*

YesNo
Have you ever house-broken a dog or puppy before?*

YesNo
If the dog has an "accident" in your home, what type of correction do you plan to use?*
How many hours each day will your new pet be home alone?*
Where will your new pet sleep at night?*
How will you supervise the dog's outdoor activity?*
Where will your new dog stay when nobody is home?*
What length of time will you allow your new pet to adjust to his new home?*
Are you willing to work through your new pet's issues, if any?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Do you understand that a dog can be an 18 year commitment, and can cost hundreds of dollars per year to care for?*

YesNo
Do you plan to take an obedience class with your dog?*

YesNoNot sure
If yes, where?
What circumstances would lead you to give up your new dog?*
Should be Empty:

Freetown Sanctuary

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information