Rescue Dog Adoption Application

Canine Adoption Application
Thank you for your interest in adopting a dog in need of a loving, forever home. Please remember that completing this application does not guarantee adoption. Every application is carefully reviewed so that we can pair each individual with the home that best suits his/her needs.
Please read the following information
- Adopter must be 21 years of age or have consent from all adults living in the household.
- We will supply all known health and medical information about your new pet. We have given a complete physical exam, parasite prevention treatment (for intestinal parasite, fleas and ear mites).
Applicant Information
Name of dog:
Your full name:*
Your age:*
Street Address:*
City:*
Province:*
Postal Code:*
Home Phone:*

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:*
Occupation:
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?

YesNo
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
Do you have any of the following?

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

YesNo
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?
Have you adopted from an animal welfare group before?

YesNo
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)*
What size of dog (when full grown) are you interested in adopting?*

SmallMediumLargeNo preference
Are you aware of crate training?*

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

YesNo
How do you plan to provide bathroom breaks for your dog?*
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 will you do with your dog if you go on vacation/what do you do with your currents dogs while on vacation*
Your dog will require exercise daily(walks/play). Are you willing/able to provide this for your dog? *
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 initially exhibit uncharacteristic behavior?*

YesNo
Do you understand that a dog can be up to an 18 year commitment?*

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

YesNoNot sure
If yes, where?
Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for?*

YesNo
What circumstances would lead you to give up your new dog?*
If you had to give up your dog, what would you do with him/her?*
Thank you for taking the time to fill out this application, and thank you for considering adding a rescued dog to your family.

Please note that, due to the high volume of applications, only applicants who are approved to adopt will be contacted directly.
Should be Empty:

Canine Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information