Adoption Application

Name

First Name Last Name

Email

example@example.com

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

I live with (check all that apply):

Spouse/Significant Other Kids Roommate(s) None

Ages of everyone living in the home (adults and kids) *

Names of dogs you're interested in specifically:

I'm interested in a (check all that apply):

Doberman Doberman Mix Small Dog Other

I'm interested in a (check all that apply):

Male Female

Do you have any size preferences/restrictions? *

I'm interested in (check all that apply): *

Black/Tan Red/Tan Blue/Tan Fawn/Tan Other

I'm interested in (check all that apply): *

Cropped Natural Ears Docked Natural Tail

I'm interested in a (check all that apply):

Puppy (under 1 year) Young (1-3 years) Adult (4-6 years) Older (7 years and older) Other

What activities do you want to enjoy with your dog? *

I would like a dog as a (check all that apply): *

Companion for another dog Companion for adults Companion for children House pet, not protective House pet, protective Outside pet, protective

I live in a: *

House Condo Apartment Other

Check the one that applies: *

I own my home I rent my home

Are you the actual home owner? *

Yes No

If not, please state the name and relation of home owner: *

*If you are the homeowner then please write "not applicable"

If you rent, do you have written permission from your landlord to have a dog/Doberman? *

*If you do not rent then please write "not applicable"

How long have you lived there? *

Are there any breed or size restrictions? *

Does your homeowner's insurance (or your landlord's liability insurance) exclude any dog breeds? *

Do you have a fenced yard? *

Yes No

If yes, please describe the height and material of fencing: *

Have you owned dogs before? *

Yes No

Do you currently have other dogs living with you? *

Yes No

How many? *

Breeds: *

Sexes? Spayed/Neutered? *

Do you own cats? *

Yes No

Please list any other animals living with you (other than cats/dogs): *

*If you have no other animals please write "not applicable"

If you have had dogs in the past then please describe why they no longer live with you (i.e. deceased, re-homed, how and why): *

How many hours a day would the dog be alone? *

Have you housebroken a dog before? *

Yes No

Please describe how you would housebreak a dog: *

Are you potentially ready to adopt and take home a dog on the day you visit?

Form

Adoption Application