Dog Application

1
Name of dog(s) you’re interested in adopting:* This field is required.
2
Your Name:* This field is required.
First Name
Last Name
3
Your age:
4
Home Address (no P.O. Boxes):* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Phone Number:* This field is required.
Please enter a valid phone number.
6
Alternate Phone Number* This field is required.
Please enter a valid phone number.
7
Email:* This field is required.
example@example.com
8
Are you presently:* This field is required.
Employed
Student
Between Jobs
Retired
Other
9
If employed, who is your employer and what is your position? (Put NA if not employed) * This field is required.
10
Names, ages and genders of all adults in your household: Please include their relation to you. * This field is required.
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11
Genders and ages of children in the home, if any: If none, put NA. Include children that visit frequently such as grandchildren.* This field is required.
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12
Is your entire household in agreement to proceed with adoption?* This field is required.
YESNO
13
Who will be the dog’s primary caregiver?* This field is required.
14
How long have you lived at your current address? * This field is required.
15
Do you rent or own?* This field is required.
Rent
Own
16
What is your housing situation?* This field is required.
House
Apartment
Condo
Mobile Home
Farm/Ranch
Other
17
If you rent, what is your landlord’s name and phone number? If you own, put NA. * This field is required.
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18
If you rent, is there a pet deposit?* This field is required.
Yes
No
Unsure
Not Applicable
19
Are there any restrictions from your landlord or subdivision? * This field is required.
YESNO
20
Do you have a fully fenced yard?* This field is required.
YESNO
21
If yes, type of fence and height:* This field is required.
22
Do you have a pool or any other large bodies of water on your property? * This field is required.
Yes, fenced.
Yes, not fenced.
No
23
Do you have a dog door?* This field is required.
YESNO
24
Have you owned a dog before?* This field is required.
YESNO
25
If yes, what years did you own the dog? If no, put NA.* This field is required.
26
Why do you no longer own the dog?* This field is required.
27
Have you ever surrendered an animal to a shelter? If yes, please share the circumstances. * This field is required.
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Have you ever returned, adopted out or given away an animal you adopted or purchased? If yes, please share the circumstances. * This field is required.
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29
Have you ever had to euthanize an animal? If yes, please share the circumstances. * This field is required.
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Please list type, breed, gender, weight and ages of any animals in the home: Include small caged pets and barnyard animals.* This field is required.
31
Which of your animals are spayed/neutered?* This field is required.
32
Are they UTD on vaccines, flea/tick and heartworm preventative? * This field is required.
YESNO
33
What is your family’s lifestyle like?* This field is required.
Active and on the go.
Quiet and relaxed.
Entertain frequently.
Lots of kids in and out.
Travel frequently.
34
I want my dog to be a…. (Check all that apply)* This field is required.
House pet
Watchdog
Hunter
Companion for other pets
Gift
For the children
35
Temperament Preferred:(check all that apply)* This field is required.
Active
Sedate
Lapdog
Very active
Gentle
Playful
Affectionate
Shy
Intelligent
Independent
Protective
Activity partner
Couch potato
Walking partner
36
Will you provide house training if necessary? * This field is required.
YESNO
37
Will you provide obedience training?* This field is required.
YESNO
38
I would like my dog to get along with: (check all that apply)* This field is required.
Other dogs
Cats
Birds
Farm animals
Small caged rodents
Children
39
Why have you chosen to adopt a dog?* This field is required.
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40
How many hours per day will the dog be alone?* This field is required.
41
Where will the dog be kept when no one is home?* This field is required.
42
Where will the dog be kept when you are home? * This field is required.
43
Where will the dog be kept at night?* This field is required.
44
How will you supervise the dog’s outdoor activity? * This field is required.
45
How will you exercise the dog? * This field is required.
46
How will you keep the dog confined to your property?* This field is required.
In the house
Kennel
Fenced yard
Garage
Patio
Crate
With training
47
If the dog is lost, what would you do to find it?* This field is required.
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48
Have your ever worked with a professional trainer or behaviorist?* This field is required.
YESNO
49
If yes, who did you work with?* This field is required.
50
What length of time will you allow the dog to adjust to his/her new home?* This field is required.
51
What behaviors in your dog would you find unacceptable?* This field is required.
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52
If any behavioral issues arise such as (leash reactivity, stranger danger, or resource guarding), how would you go about with training?* This field is required.
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53
Under what condition(s) would you give up your dog? * This field is required.
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54
If you must give up the dog, what would you do?* This field is required.
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55
If you move, what will you do with your pets?* This field is required.
56
Who will care for your dog when you’re out of town (vacation, etc.)?* This field is required.
57
Any additional information you would like to provide, please do so here.
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Thank you for taking the time to complete and submit our dog application. The answers will help us determine if the dog you are applying for is the best match for your family! We may not be able to respond to every application that is submitted.
59
By submitting this application, I certify that all the information in this application is true and I understand that false information may void the application. We reserve the right to deny an adoption at any time for any reason.
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