LBDR Rescue Dog Adoption Application
Applicant Information
Name of the dog you are interested in:
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Your full name:
*
Your age:
*
Street Address:
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City, State, Zip
*
Home Phone:
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Area Code
Phone Number
Work Phone:
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Area Code
Phone Number
Cell Phone:
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Area Code
Phone Number
E-mail:
Employer:
Character reference and phone number:
PayPal Transaction Number:
Household Information
Are all members of your household in agreement with this adoption?
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Yes
No
Don't Know
Who will be the pet's primary caregiver?
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Do you live in a
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House
Apartment
Condo
Other
Do you own or rent?
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Own
Rent
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?
Yes
No
Are there any restrictions from your landlord or subdivision?
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Number of pets
Size or weight restrictions
Breed restrictions
None
Do you have a fully fenced yard?
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Yes
No
Height and type of fence
Do you have any of the following?
Underground fence
Kennel
Dog Run
How many adults are in your household?
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How many children are in your household?
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If children, what are their ages?
Have your children been around animals before?
Yes
No
Does anyone in your home have allergies to dogs or have asthma?
*
Yes
No
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages
How many of these pets are spayed/neutered?
Where are these animals now?
Have you adopted from an animal welfare group before?
Yes
No
If yes, what group?
Have you ever given up a pet?
Yes
No
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)
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Are you aware of crate training?
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Yes
No
Have you ever house-broken a dog or puppy before?
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Yes
No
If the dog has an "accident" in your home, what type of correction do you plan to use?
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How many hours each day will your new pet be home alone?
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Where will your new pet sleep at night?
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How will you supervise the dog's outdoor activity?
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Where will your new dog stay when nobody is home?
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What length of time will you allow your new pet to adjust to his new home?
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Are you willing to work through your new pet's issues, if any?
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Yes
No
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?
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Yes
No
Do you understand that a dog can be an 18 year commitment, and can cost $500-$1000 per year to care for?
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Yes
No
Do you plan to take an obedience class with your dog?
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Yes
No
Not sure
If yes, where?
Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for?
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Yes
No
What circumstances would lead you to give up your new dog?
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If you had to give up your dog, what would you do with him/her?
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How did you find out about LBDR?
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Petfinder.com
Facebook
Friend/Family Member
Other website
Other
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
Submit
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