OBO Adoption Application

Dog Adoption Application
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How long at this address?: *
Are you planning on moving within the next 6 months? *

Yes No
If yes, what are your plans for your pets if you move?
Home Phone Number

Area Code Phone Number
Cell Phone Number

Area Code Phone Number
Work Phone Number

Area Code Phone Number
Name of Employer:
Up until what time of night can we contact you via phone? *
E-mail *
Are you 18 years of age or older? *

Yes No
Birth Date *

Month Day Year
Do you own your own home? *

Yes No
If no, name and phone # of landlord. THIS MUST BE FILLED OUT OR YOUR APPLICATION COULD BE DENIED.
Type of Dwelling: *
Full name and age of ALL occupants in household (including yourself). THIS MUST BE FILLED OUT FULLY OR YOUR APPLICATION COULD BE DENIED *
If no children, do you plan on having children or will children be visiting the household frequently? *

Yes No
What is your reason for wanting to adopt a dog? *

Housepet Companion Companion for pet Gift Guard Dog Other
If other, please explain:
How many total hours will your new pet be left alone during the day? For extended hours what are your plans for the pet? Please explain in full. *
How many total hours will your new dog be outside alone during the day? *
If adopting a puppy, where would the puppy be kept when alone?
Do you have a fenced yard? *

Yes No
If yes, which type of fence? *

Wood Chain Link Split Rail N/A
If yes, how tall is your fence?: *
Do you have locks and/or latches on all your gates? *

Yes No N/A
Will your adopted dog or do your current dogs be put on a tie out? *

Yes No Not sure
Are any members of your household allergic to animals? *

Yes No
If yes, please describe:
Who will have chief responsibility for the care of your new pet? *
Over the past 5 years, how many pets have you owned? (Include current pets) *
List each individually including name, breed, age, still living with you? (if not, why?)
Have you and your spouse (if applicable) ever owned a pet together? *

Yes No N/A
If yes, when?
Have you ever lost or given away a pet? IF YES, PLEASE EXPLAIN AT END OF QUESTIONNAIRE *

Yes No
If you currently own a dog or cat, how does he/she react to new pets?
Are your present pets up-to-date on their annual vaccines? *

Yes No N/A
If no, please explain:
Are your present pets spayed or neutered? *

Yes No N/A
If no, please explain.
Were your previous pets spayed or neutered? *

Yes No N/A
If no, please explain.
How much are you financially prepared to spend for routine/emergency medical care, licensing, etc? *
What plans do you have for your new pet when you are on vacation? *
Which dog(s) are you interested in? *
Age of dog you would consider adopting: (check all that apply) *

Puppy Young Adult Special Needs Senior Bonded Pair
Can/Will you provide your dog with monthly heart worm/flea/tick prevention? *

Yes No
Who is your current veterinarian and veterinarian for all pets listed ? Please provide their NAME and PHONE NUMBER. PLEASE CONTACT YOUR VET TO RELEASE THEM TO TALK TO US. *
If your dog displays behavioral problems (such as jumping on people,excessive barking, potty accidents, etc.) how would you go about correcting the behavior? *

Contact a Professional Use a book Personal Knowledge Other
If other, please explain:
What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)? *

Try crate training Use positive enforcement Use potty pads Have dog examined by vet Use a dog door Return dog None Other
If other, please explain:
Is your entire immediate family in agreement with the decision to bring a new pet into your home? *

Yes No
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 15 - 20 years (average life span)? *

Yes No
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care? *

Yes No
If yes, please describe:
Have you ever adopted or tried to adopt a pet from us before? If yes, fill out info below. *

Yes No
Pet’s Information

Pet’s Name Cat or Dog? Adoption/Application Date
Where will your dog spend most of his/her time? *
If you selected outdoor, would your dog be supervised?

Yes No
YOU MUST CRATE TRAIN YOUR DOG TO PREVENT ANXIOUS AND FRUSTRATED TENDENCIES. CAN YOU DO THIS?

Yes No
Where will your dog eat? *
Where will your dog sleep? *
Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.
Reference #1 *
First and Last Name & Relationship to Self
Reference # 1 Phone Number *

Area Code Phone Number
Reference #2 *
First and Last Name & Relationship to Self
Reference #2 Phone Number *

Area Code Phone Number
If there is anything else you think we should know, please note it here.
Please remember, it may take approximately 2 to 5 business days for us to get back to you.

PLEASE NOTE IF YOU DO NOT FILL THIS APPLICATION OUT IN FULL YOU MAY BE DENIED.
PUPPY ADOPTIONS

**IF APPROVED FOR ADOPTING A PUPPY FROM US YOU WILL BE ASKED TO PAY HALF OF THEIR ADOPTION FEE AT TIME OF PRE ADOPTION MEET AND GREET - WHICH IS NON REFUNDABLE. THIS GOES TOWARDS THE DEPOSITS ON THEIR CARE. ALSO INSURING SERIOUSNESS OF ADOPTING. THIS HELPS AVOID OURS PUPPIES WAITING LONGER THEIR FOREVER HOMES.**
Thank you so much for wanting to rescue a dog!!
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Dog Adoption Application

Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.

Please remember, it may take approximately 2 to 5 business days for us to get back to you.

PUPPY ADOPTIONS

Thank you so much for wanting to rescue a dog!!