Dog Adoption Application

Dog Adoption Application
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
About the dog(s) you are seeking:
If you are seeking a specific pet from our agency, please tell us his or her name and why you would like to adopt him or her.
If you don't have a specific pet in mind, please tell us about the type of dog you would be interested in, so we can recommend a perfect match:
I prefer:

MaleFemaleNo Preference
I prefer:

PuppyYoung AdultAdultSeniorNo Preference
Of course they are adorable. But, if you are interested in a puppy, will you happily work to train your new addition, even when he or she exhibits typical puppy behaviors, such as:

urinating on and soiling the floor or carpet

chewing up shoes, toys, and furniture

digging in the yard

barking and yowling through the night

jumping up and scratching your doors, other people, and pets

incessantly nipping your fingers and ankles, when teething
Still think you can take it?

YesNo
This dog will live:

Primarily indoors, with outdoor exerciseOutdoors as a yard dog
In terms of dog's breed or appearance, I would prefer a dog of this discription:
I prefer a dog with an energy, activity, and/or attentiveness level of this description: (Check all that apply)

Very playful and high energylaid back and easy goingsmart, well trained, and/or able to learn commandsVery affectionate, expressive, and responsiveProtective of the householdMost in need of a home
I want to adopt this dog: (Check all that apply)

Primarily as a pal or companionTo provide security and help protect my familyPrimarily serve as a guard dogTo accompany on fishing and hunting tripsTo teach my child/children responsibilityAs a gift for a loved one or someone special
My dog will: (Check all that apply)

Never ride in my vehicleOccasionally ride in my vehicleAccompany me on trips to the park or storeEnjoy riding in the back of my truckSometimes be left unattended in the vehicle when I run errands
My dog will get his or her exercise: (Check all that apply)

In my yardOn regular short walksOn a long daily walkAt the local dog parkWhen my son or daughter walks him or her
Is there anything else you'd like to tell us about the sort of dog you'd like to adopt?
ABOUT ME AND MY HOUSEHOLD
Do you currently live with pets?

YesNo
If yes, please describe them. Include details about their species, breed, age, and temperament. Also, let us know if they are spayed and/or neutered or microchipped.
If you have one, please provide your veterinarian's name and contact information.
If you have had pets in the past, please tell us about them. Include details about their species, breed, whether or not they were spayed and/or neutered and/or microchipped. Also, please let us know if they passed away, if they were lost or something happened to them, or if they are living with someone else at present.
Do you own or rent your place of residence?

OwnRent
If you rent, please provide your landlord's contact information, if we may contact him or her:
Tell us about your family or household. Please include details such as names and ages of your family members or housemates, as well as their relationships to you:
Is everyone in agreement to adopt a dog as described above?

YesNo
I would best describe my home as a:

TrailerApt/CondoSmall HouseLarge House
I would best describe the noise and activity level in my household as follows:

LowMediumHigh
In terms of housekeeping, I would best describe my household as:

Cozy/ Lived InNeat and TidyImmaculate
If there are any pet behaviors that you or any of your household members will not tolerate, please describe them.
If a new household member arrived at your residence, and that person feared, disliked, or was allergic to this pet, what would you do?
If your pet became lost, what would you do to find him or her?
What will you do with your pet, if you are forced to evacuate, as a result of a hurricane or other natural disaster?
If this is an out of state adoption, please indicate the manner in which you prefer to take custody of the pet:

Sponsor the cost of my pet's air transportationTravel to Louisiana to pick up my petHave someone in my immediate family pick up the animal.
If you could not continue to keep this pet for any reason, would you agree to return him or her to us, even if the pet is located in another state at the time?

YesNo
Is there anything else you would like to discuss with us concerning this adoption?
Please List the Name and Phone number for your Vet. Also, the names your records will be listed under.*
Please include 2 personal references who are not related to you.*
Thank you SO much for taking the time to complete this application!!!

An Adoption Counselor will be in touch with you soon. We'll do our best to match you with the perfect dog, who best suits your lifestyle and would thrive in your household.
Should be Empty:

Dog Adoption Application

About the dog(s) you are seeking:

ABOUT ME AND MY HOUSEHOLD