CREO EN TI Dog Adoption Application form

To be considered as an adopter, you must:

▪️be 21 years of age or older.

▪️have the knowledge and consent of your landlord (if applicable).

▪️be able and willing to spend the time and money necessary to provide medical treatment and proper care of the pet.

▪️all dogs/cats in the home must be up to date on vaccines and must be spayed/neutered if they are 6 months or older, unless there are medical reasons for not doing so.

We are an all-volunteer, non-profit, animal welfare organization dedicated to the rescue and placement of stray, neglected and abused animals.

We are completely funded through fundraising efforts and public donations. All of our pets are cared for by foster homes and receive complete medical care, which includes deworming, vaccinations, spaying/neutering and microchipping prior to their adoption.

This questionnaire is designed to help us and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption.

We reserve the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!

Today's date:*

Name of the dog you are interested in:*

Name of the applicant:*

Address:*

City:*

State:*

Zip code:*

Home Phone:

Area CodePhone Number

Work Phone:

Area CodePhone Number

Cell Phone:*

Area CodePhone Number

Email address: *

Date of birth: *

Your age:*

What is your occupation?*

Current employer:*

Facebook: *

Instagram: *

Are all members of your household in agreement with this adoption?*

YesNoDon't Know

Do you live in a*

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

What kind of fencing will contain your pet?*

Height and type of fence*

Is the fencing in good repair with no holes or gaps?*

Are you adopting for yourself or somebody else?*

Who will be the pet's primary caregiver?*

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

List any pets you have owned in the past five years, and their ages: *

What animals do you currently have? (please give sex, age and breed)*

How many of these pets are spayed/neutered?*

What happened to the pets you no longer have?*

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:*

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 $300 - $500 per year to care for?*

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?*

How did you find out about our Rescue?*

If there is any additional details you wish to add, please list here!*

I understand and assume full responsibility for the information given here is all true and correct, and for the welfare of this pet from the date of adoption. Signature*

We will review your application and get back to you as soon as possible! Please keep in mind that we are all volunteers and work full time jobs.

Thank you for your interest in one of the pets in our rescue!

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information