Clone of Dog adoption application

Date

MonthDayYear

For a specific dog- Who are you interested in?

If the specific dog you are interested in is not available or a good match, are you interested in other possible matches?

If you do not have a specific dog, Please tell us what you may be looking for? Size, Gender, Age, Breed...

How soon are you looking to adopt?

Full Name*

First NameLast Name

Date of Birth

Date of birth

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Email Address*

Home Phone Number*

Area CodePhone Number

Cell Phone Number

Area CodePhone Number

Which phone number would you prefer to be called on?

Current Employer

Position at Employer

Amount of time you have worked at your current job

Current Employer of Spouse

Position of employment of Spouse

Amount of time your spouse has worked at their current job

Do you rent or own?*

House or Apartment?

If renting, do you have your landlord's permission to keep a dog?

Landlord's name

Landlord's Phone Number

How long have you lived at your current address?

Do you have a fenced in yard?

What type of fencing and what height?

Do you travel often?

If traveling often, what do you plan on doing with your dog during that time?

Please describe your home and yard.

What do you consider your home environment like?

Will your dog live indoors?

Is this your first dog/puppy?

On average how many hours will the dog stay alone each day?

Where will the dog spend the day?

Where will the dog spend the night?

Do you have a regular veterinarian?

IF YOU HAVE OWNED A DOG OR CAT IN THE LAST 10 YEARS AND DO NOT HAVE A REGULAR VET, PLEASE GIVE A REASON WHY.

Veterinarians Name

Veterinarian's Phone Number

How long have you been with this vet?

Have you notified your vet that we will be calling for information?

If records at your vet are NOT under your name, please provide the name it will be found under.

Do you understand that if you have not called your vet to release information to us, we will NOT process your application.

Have you ever surrendered an animal to a shelter, rescue group or given one away?

If yes, please describe the circumstances.

What do you plan to do with your dog if you decide or are forced to move?

Do you have any other pets currently?

If yes, Please list the following information: NAME, SPECIES, AGE, BREED, GENDER

Are they spayed/neutered and vaccinated?

If NOT, please explain why.

What brand of food do you feed your animals?

Do you have children?

If yes, how old are your children?

Please list ALL people in your house hold with names & ages.

Is anyone in your family allergic to animals?

How did you hear about us/this animal?

If you are approved by other rescues please provide the name.

Dogs can live on average 15 years. Are you willing to make the commitment to care for this animal for its entire lifetime?

Please list 3 NON FAMILY MEMBER references.

Reference #1*

Phone number*

Relationship*

Reference #2*

Phone number*

Relationship*

Reference #3*

Phone number*

Relationship*

Our adoption fee range from $200-$500. The adoption fee for ALL puppies under the age of 1 year old, small breed dogs & pure breed dogs is $500, the adoption fee for MOST adult dogs over 1 year old is $400. (adoption fees can be different for every dog and are subject to change depending on the dog's needs & condition.

ALL of our animals are spayed/neutered, microchipped, up to date on age-appropriate vaccines, dewormed, and on preventives prior to leaving our facility.

Canine Adoption Application