Dog Adoption Application

Dog Adoption Application
Lillian Allbon Cumberland County Animal Shelter

798 Smith Road, Upper Nappan

Amherst, NS B4H 3Y4

Phone: (902) 661-7297
Once a dog is available for adoption, we will usually receive a number of applications (especially for the more popular small dogs), we will review all applications and choose the one that is the best fit for the dog. Once the successful applicant is advised we will then email or call all other applicants (limited to the first 25 applicants) to advise on the status of the application.
Date*

MonthDayYear
Date
Are you applying for a dog or puppy?*

DogPuppy
Name of animal (if applicable)
Your Name*

First NameLast Name
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Primary Phone
Please enter a valid phone number.
Secondary Phone
Please enter a valid phone number.
How do you prefer to be contacted?

Phone CallEmail
Spouse / Partners full name (if applicable)

First NameLast Name
How long have you been at this address*
years
If LESS than 3 years, please add your previous address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you live in a:*
Are pets allowed in your residence?*

YesNo
Landlords Name
Landlords Phone Number
Please enter a valid phone number.
Are you:*
If you have children living in the household full or part-time, please list their ages
Which member of the household will be responsible for feeding the dog?*
Which member of your household will be responsible for training the dog?*
Please check all of the following reasons why you are adopting a dog:*

CompanionGiftBreedingFor a childCompany for pet
If adopting as a gift, for who?

What pets do you own or have owned in the last 10 years?

	Cat or Dog?	Breed	Pets Age	Sex	Spayed / Neutered?	Still, Owned?
Pet #1
Pet #2
Pet #3
Pet #4
Pet #5

Which Veterinarian looked after your pet?
Veterinarians phone number
Do you give permission for the L.A Animal Shelter to contact your vet for more information*
Do you vaccinate your pet(s) annually?*
If you answered No, please provide a reason why?
If you no longer own your pet(s), what became of them?
If you move, what will you do with your dog?
What will you do with your pet when you go on vacation?*
If not done so already, do you plan to spay or neuter your pet?
If adopting a female, do you plan to let it have a litter before spaying?
How long will your dog be left alone each day?
hours
What type of I.D will you use for your dog? (i.e microchip)
How many times a day do you plan to walk your dog?
Do you plan to take your dog to training classes?
Do you have a yard? Is it fenced?
Do you plan to tie your dog outside?

Please list the names and contact information of 3 references (not family members)

	Full Name	Contact Information (Phone number or email)	Relationship
Reference 1
Reference 2
Reference 3

Signature

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