Baltimore Humane Society Dog Adopter Application

Dog Adoption Application

1601 Nicodemus Rd | Reisterstown, MD 21136 | 410-833-8848 Ext/Opt 2
Our goal at The Baltimore Humane Society is to ensure the best possible match for the adopter and animal. Each animal has unique characteristics and specific needs. We make every effort to ensure that animals are matched with suitable adopters so they can remain in their new homes for life.

Please complete the following application to begin the process. This application is for our dogs in general, not for a specific dog in our care. We are open for walk-in visitations on Mondays from 12:00pm to 3:30pm and Tuesday through Sunday from 12:00pm to 4:30pm. NO APPOINTMENT NECESSARY. Please contact the adoption center at 410-833-8848 Ext 2 or animalcenter@bmorehumane.org if you have any questions.
Applicant's Legal First & Last Name:*

First NameMiddle NameLast Name
Date of Birth:*

MonthDayYear
Date
Government Issued ID Number (i.e. driver's license)*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
County of Residence: (City, Baltimore, Carroll, Howard, etc.)*
Cell Phone Number:*
Please enter a valid phone number.
Home Phone Number (if applicable):
Please enter a valid phone number.
Email Address*
Are you a first responder?*
Are you active military or a veteran?*
Not including yourself, how many people actively live in your home with you?*

How would you describe your household? (check all that apply)*

QuietBusyActiveLoudCrowdedNoisyOther
What type of housing describes your residence?*

Single family homeApartment/CondoTownhouseMobile homeDuplexMilitary Housing
Do you rent or own?*

RentOwn
Are there any restrictions regarding pets enforced by your landlord?*
What are the restrictions regarding pets where you live?*
Is there a yard available at your residence?*

YesNo
Is your yard completely fenced in?

YesYes, but it's a communal dog parkNoNo, but I plan to install a fence
Are you currently employed?*

YesNo
Do you typically work from home or go into the office?*

I work from home exclusivelyI work in the office exclusivelyI work from home and I go into the office
What is your source of income?*
I am adopting for:*

MyselfA family memberSomeone else
Have you ever adopted/owned an animal before?*

YesNo
If you've adopted/owned an animal before, where are they now?*

Live with meRehomed to friend/family memberSurrendered to a shelterRan awayPassed awayOther
Please explain why your animal is no longer in your care.*
Do you currently have pets living in your home?*

Are you committed to taking full responsibility for your new dog's health and welfare for the rest of their life, which could be 10 years or more?*

YesNo
We need to verify your current pets are up to date on their rabies vaccine before adoption. Please upload their certificate below to expedite the pre-approval process.

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Do you or any members of your household have allergies to dogs?*

YesYes, but we take medication for themNo
What are the reasons you'd like to adopt a dog? (check all that apply)*

Companion for a childProtection for my familyCompanion for another petGuard businessCompanionship for myselfGift for someone elseOther
Name of Vet Hospital/Clinic*
Phone Number of Vet Hospital/Clinic*
Please enter a valid phone number.
Where will your new dog spend their time when home alone? (check all that apply)*

Indoors - garageIndoors - basementIndoors - own roomIndoors - crateIndoors - free runOutdoors - dog house/penOutdoors - on chain/tie outOutdoors - fenced areaOther
On average, how many hours a day will your new dog be left home alone?
Where will your new dog sleep at night? (check all that apply)*

Indoors - free runIndoors - dog bedIndoors - family member's bed/roomIndoors - basementIndoors - crateIndoors - garageOutdoors - fenced areaOutdoors - dog house/penOutdoors - on chain/tie outOther
How would you handle any unwanted/destructive behaviors? (check all that apply)*

Provide appropriate toysTimeoutPhysical punishmentCrateYell at dogPut dog outsideSmack/hitOther
How important is it to you that your new dog be able to adjust to new situations quickly?*

Very ImportantSomewhat ImportantNot Important
How much training are you willing to do with your new dog?*

As much as it takesSomeNoneI would like to learn about training opportunities
What types of training methods do you prefer? (check all that apply)*

Positive reinforcement/reward-basedElectronicAlpha/dominanceI am not sureOther
What tools would you use for training? (check all that apply)

Prong collarShock collarChoke chainTreats/rewardsSquirt bottlePhysical punishmentClickerI am not sureOther
Under what circumstances would you consider giving up/surrendering your dog? (check all that apply)*

MovingDivorce/separationNew babyEscaping fenced areaAllergiesToo time consumingPet's medical problemsSheddingDestructive behavior/other behavioral problemsChildren lost interestPersonal medical problemsIncompatible with other petsFinancial problemsNone: I would try everything to keep my new family member
How did you hear about The Baltimore Humane Society? (check all that apply)*

Family/friend/colleagueTV commercialRadio commercialPrint advertisementSocial mediaGoogle searchAnother shelter/rescueOther
I understand that completing this online application does not guarantee me a dog adoption from The Baltimore Humane Society and I acknowledge that its purpose is to ensure a strong match between each potential adopter and pet in their care. I further agree to respect the organization's adoption policies and have provided the information above truthfully and to the best of my knowledge.*

I understandI do not understand and need clarification
I understand that this online application is general and not for a specific dog, until I physically meet the dog at the Baltimore Humane Society. I understand that the Baltimore Humane Society operates on a first come, first serve basis.*

I understandI do not understand and would like clarification
Should be Empty:

	First Name	Last Name	Date of Birth
Household Member #1
Household Member #2
Household Member #3
Household Member #4
Household Member #5
Household Member #6
Household Member #7

	Type of Animal	Name	Breed	Age
Pet #1
Pet #2
Pet #3
Pet #4
Pet #5

Dog Adoption Application