Dog Adoption Application Form

Dog Adoption Application

Perspective Pet Parent*

First NameLast Name

Name of Dog You Wish to Adopt*

Phone Number*

Email Address*

example@example.com

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Do you own any pets?*

Pet Name(s)(Include Previous Pets)*

Where are these pets now? *

Please provide your veterinarian's name and phone number:*

Are you pets on monthly preventatives?*

YesNo

Do you own or rent your home?*

OwnRent

Do you have a fenced in yard?*

YesNo

Do you live in a*

HouseApartmentMobile HomeOther

If "Other" was selected in the previous question, please explain.

If you do not have a fenced in yard, how do you plan on exercising it? *

If you rent, please provide your landlord's information here:

Please list all household members and their ages. (Including Applicant)*

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?*

YesNo

If you answered "Yes" to the above question, please provide detail:

How many hours per day would the pet be alone?*

Will you crate your pet?*

If you have to leave town, emergently or planned, where would your pet stay?

How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*

It can take several weeks to months for your new animal to adjust to its new home and family. Are you prepared to work with the animal during this adjustment period?*

YesNo

What reasons would cause you to give up a pet? Would you be willing to seek out training to correct these issues?*

Is there any information you feel we should know regarding the home, how you can provide for the pet, etc.?

Please provide the names and contact numbers for 2 personal references (no family members please):*

By submitting this application, I understand Mason County's Pets Without Parents will check my references including veterinary and personal.
By submitting this application, I understand there is an adoption donation associated with adoption of a pet from Mason County's Pets Without Parents. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
By submitting this application, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Mason County's Pets Without Parents.
By submitting this application, I agree to indemnify and hold harmless Mason County's Pets Without Parents against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
By submitting this application, I understand that Mason County's Pets Without Parents will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
By submitting this application, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Mason County Pets Without Parents and provide transport to where Mason County Pets Without Parents deems appropriate.
By submitting this application, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent*