Dog Adoption Application

Dog Adoption Application
Name of dog you are in interested in
Name*

First NameLast Name
Your age*
NOTE: You must be at least 21 to adopt from Carol’s Senior Pet Sanctuary.
Proof of age will be required prior to completing adoption.
Are you able and willing to visit our shelter in Sayville, NY:*

YesNo
NOTE: A visit to Carol’s Senior Pet Sanctuary is required for all pet adoptions. Do not submit this application unless you can commit to a shelter visit to complete the application process.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Your place of employment and
Place of employment phone number
Please enter a valid phone number.
Spouse or partner's name
Spouse or partner's work telephone
Please enter a valid phone number.
About Your Home
Please complete this section for the household in which your dog will reside. At least one home visit will be required before your application is approved.
Type of residence
Do you:
If you are a renter or live in a condo, does your landlord/association allow dogs?

YesNo
Name of Landlord or Condo Association
Phone Number
Please enter a valid phone number.
How long have you lived at this address?
Any plans to move in the next few years?

YesNo
How many times have you moved in the past five years?
What would you do if you moved to a residence where dogs are not permitted?
About Your Family
How many adults live in this household?
How many children live in this household and their age?
Number of children who visit and their age?
Are all members of your household in agreement about adopting a dog?

YesNo
Is there anyone in your household that is nervous or unsure around dogs?

YesNo
For whom would you be adopting this dog?
Who will be the primary caregiver for this animal? Who will be financially responsible for this animal?
Are you willing to have all members of your household come to Carol’s Senior Pet Sanctuary to meet the animal(s) in which you are interested?

YesNo
Do any members of your household have asthma, or have allergies to dogs? If yes, who?
Describe your household activity/noise level
How often do you travel? How will you care for your dog when you are away from home?
In the event of an emergency, who would care for your dog or what arrangements would you make?
For how many hours would the dog be alone during the day? (please consider what time you leave for work and what time you return home)
About Your Current Pet(s)
Please provide: name, species/breed, age, gender, spayed/neutered, had how long, up-to-date on vaccinations?
If you have a cat, does it get along with dogs?

YesNo
If you have a cat, is it declawed?

YesNo
If you have a dog, does it get along with other dogs?

YesNo
What veterinary hospital do your animals go to? May we call to verify vaccinations and spay/neuter status?
Are you experiencing any difficulties with your current pets in terms of health or behavior? If yes, please describe:
Pet History
Have all of your family members been around dogs?

YesNo
Have you had the experience of being primary caregiver to a dog?

YesNo
Have you ever given a pet away, given it to a shelter or rescue group, returned it to a breeder or sold it?

YesNo
Have you ever had a pet for a short period of time and it didn't work out?

YesNo
Have you ever had an animal lost or stolen?

YesNo
Have you ever had to retrieve your animal from a pound, shelter or animal control facility?

YesNo
Have you ever had an animal die as the result of being hit by a car, being poisoned or from unknown causes?

YesNo
Have you had a dog that gave birth?

YesNo
Have you previously applied to adopt from Carol’s Senior Pet Sanctuary?

YesNo
Have you ever adopted a pet before? If so, what type of animal and from where?
Pets owned over the past 10 years. Please provide: name, species/breed, spayed/neutered, owned how long, what happened to this pet, how long ago, vet you used.
Plans for Your New Pet
Will the dog live:
Where will the dog be when nobody is home?
Do you have a fenced yard?

YesNo
What veterinary practice do you plan to use?
If you adopt an animal who has not been spayed or neutered do you:

Intend to have it spayed/neuteredIntend to let it have puppiesNot sure
Are you aware that some dogs require a period of weeks or even months to adjust to their new home/environment/family/other pets?

YesNo
Are you willing to allow for this adjustment period?
Are you willing to bring your pet to a veterinarian for yearly exams, and for vaccinations per your veterinarian's recommendations?

YesNo
Are you able/willing to pay for emergency care, which could result in a bill of $200 to $1,000 or more?

YesNo
Are you able/willing to pay for pet expenses including veterinary care, supplies, toys, boarding/pet sitting, grooming, food, etc.?

YesNo
Are you able to commit to providing a home for a dog for the life of the dog?

YesNo
What circumstances might justify giving up a dog? (check all that apply)

BabyMovingSheddingWant to travelDivorceAllergiesBehavior problemsDog becomes illDog not getting along with other petsNew household member dislikes dogHouse soiling/urine markingDestructiveChildren lost interestToo time consumingNoneOther
If your dog exhibits behavioral or adjustment issues, would you be willing to seek the advice of a Carol’s Senior Pet Sanctuary representative?

YesNo
Would you be willing to pay for obedience or behavioral sessions?

YesNo
Preferences
I prefer a dog that is:
Reasons for adopting

CompanionshipWatch dogOther
Energy level preferred
I intend to (check all that apply)

Walk dog on a leashWalk dog off leashBring dog to a dog parkHunt with dogGo jogging or hiking with the dogLet the dog exercise himself in the yard
I prefer a dog who is (check all that apply)

AdultSeniorPuppyMaleFemaleSpayed/neuteredIndoor onlyIndoor/outdoorOutdoor onlyMellow/quietLap dogProtectiveVery active/energenicMainly an outdoor dogHappy to meet new peopleHypoallergenicLikely to be house trained
Breeds/mixes I prefer
When it comes to relating to dogs, I consider myself:

Strict, demanding, a strong leader (dog must sit for a cookie and follow my rules)Lenient, a little wishy washy, easily coerced by the dog (the dog looks cute so he gets a treat without sitting, can jump on the couch uninvited)Somewhere in between
My ideal dog would
Bad doggie habits I cannot tolerate
Please share with us anything you would like for us to know about the new dog that you would like to add to your family
Would you be interested in learning about some of our 'special needs'or 'long-term resident' dogs?

YesNo
Would you be willing to have an in-home visit by a Carol’s Senior Pet Sanctuary representativeafter you have adopted from us?

YesNo
Please provide three personal references (name, relationship, phone number)*
By clicking the Submit button below, I certify that:

The information I have given is accurateI understand that Carol’s Senior Pet Sanctuary has the right to deny any applicationI give permission for a representative of Carol’s Senior Pet Sanctuary to call the references and veterinary practices I have listedI understand that a home visit as well as a visit to Carol’s Senior Pet Sanctuary in Sayville, NY is required for every pet adoption applicationI understand that an adoption fee is due at the time of approvalI understand that at any time, if I cannot properly care for this adopted pet, the pet shall be returned to Carol’s Senior Pet Sanctuary
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Dog Adoption Application

About Your Home

About Your Family

About Your Current Pet(s)

Pet History

Plans for Your New Pet

Preferences