Dog Adoption/Foster application Form

Adoption Application
Full Name (Required field)

First NameLast Name
E-mail (Required field)
Address (Required all fields)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number

Area CodePhone Number
Birth Date

MonthDayYear
Are you employed/retired? (Required field)
Where are you employed? How long?
Do you own your own home? (Required field)
If renting: Landlord name and contact number

Namecontact number
List names & ages of all whom reside or stay in your home:
If no children, do you plan on having children or will children be visiting the household frequently? (Required field)
What is your reason for wanting to adopt a dog? (Required field)
If other, please explain:
Veterinarian information

Clinic namecontact number
How many total hours will your new pet be left alone during the day? (Required field)
If adopting a puppy, where would the puppy be kept when alone?
Do you have a fenced yard? (Required field)
Will your adopted dog or do your current dogs be put on a tie out? (Required field)
Are any members of your household allergic to animals? (Required field)
Over the past 5 years, how many pets have you owned? (Include current pets)
List all pets living with you and those deceased: name, species, age
Are your present pets up-to-date on their annual vaccines? (Required field)
If no, please explain:
Are your present pets spayed or neutered? (Required field)
If no, please explain.
How much are you financially prepared to spend for routine/emergency medical care, licensing, etc? (Required field)
Do you have a swimming pool:
If yes, what steps will you take to ensure your new dog's safety:
What plans do you have for your new pet when you are on vacation? (Required)
Which dog(s) are you interested in?
Can/Will you provide your dog with monthly heart worm/flea/tick prevention? (Required field)
If your dog displays behavioral problems (such as jumping on people,excessive barking, potty accidents, etc.) how would you go about correcting the behavior? (Required field)
If other, please explain:
Is your entire immediate family in agreement with the decision to bring a new pet into your home? (Required field)
If anyone is NOT, please explain:
Where will your dog spend most of his/her time? (Required field)
If you selected outdoor, would your dog be supervised?
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 (Required field)
First and Last Name & Relationship to Self
Reference # 1 Phone Number (Required field)

Area CodePhone Number
Reference #2 (Required field)
First and Last Name & Relationship to Self
Reference #2 Phone Number (Required field)

Area CodePhone Number
Please note if you are applying to foster or to adopt.
Please remember, it may take approximately 2 to 3 business days for us to get back to you.
Thank you so much for wanting to rescue from Shar Pei Nation Rescue!!
Signature
Should be Empty:

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 3 business days for us to get back to you.

Thank you so much for wanting to rescue from Shar Pei Nation Rescue!!