Dog Adoption Application

Name of DOG you are interested in?:

What attracted you to this DOG?:

Applicant Full Name

Co-Applicant Full Name (IF APPLICABLE)

Applicant's Street Address:

Applicant's City:

Applicant's State:

Applicant's Zip:

County of Residence:

Applicant's Phone Number:

Applicant's Alternate Phone Number:

Co-Applicant's Phone Number:

Applicant's Email Address:

Place of Employment:

How many hours typically do you work per week?:

Do you own or rent your home?:

Landlord Name

Landlord's Phone Number:

Is your yard fenced?:

If you have a fence, what is the height, size and type?:

If no fence, how will you handle the dog's exercise and toilet duties?:

Do you have any children under 18 years of age? If so, please list ages:

Please list ALL pets you currently own, their breed, age, if spayed/neutered, and if on heartworm prevention:

Please list ALL pets you have owned in the past 10 years and what happened to them:

Vet's Full Name:

Vet's Street Address:

Vet's City:

Vet's State:

Vet's Zip:

Vet's Phone Number:

What energy level do you prefer

What period of time do you feel is reasonable to allow a dog to adjust?:

Have you ever given a dog away for any reason? If so, when/why?:

What would prompt you to return a pet?:

What behavior are you NOT willing to work with.

Do you plan on using a crate for your pet?:

How many hours will the pet be alone on an average day?:

Reference 1: (other than family members) who is familiar with your experience as a pet owner:

Reference 2: (other than family members) who is familiar with your experience as a pet owner:

If the pet you are interested in is NOT a fit for you based on your answers or is no longer available, please answer what best describes what you are looking for:

Yes, I have read the disclaimer and agree to these terms & conditions.