Adoption Application

Dog Adoption Application

Lulu's Locker Rescue
Please Read - Saving Your Progress:

If you are having difficulty with the application or wish to complete the application at a later time you may save your progress: Click SAVE at the very bottom of the application (next to Submit). After clicking SAVE you can (1) login if you have a Jotform account, (2) create an account, or (3) select Skip Create Account at the bottom of the popup screen. If you select Skip Create Account make sure to hit submit on the next screen that pops up. Once saved you will receive an email with a link that you click to resume your application. In order to save your progress you must have your email address entered in question #3.
(1) Please check to acknowledge the following adoption requirements:*

I am at least 25 years old.I understand that I will have a phone interview to discuss this application as part of the adoption process.I have read through the adoption process at https://www.luluslockerrescue.org/adoption-process-application so I have an idea of what to expect.
(2) Name*

First NameLast Name
(3) Email*
After you have entered a valid Email address you can click the "Save" button at the bottom of this application. This will email you a link to complete this application at a later time, if needed.
(4) Primary Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
(5) Is the provided phone number a cell phone?*

YesNo
(6) Address*

Street Address & Unit Number

Street Address Line 2

CityState

Zip Code
(7) Date of Birth*
Please use the following format: MM/DD/YYYY
(8) Is there a Co-Adopter?*
A Co-Adopter is someone who intends to remain living with the applicant and the adopted dog indefinitely and will be equally responsible for the dog's emotional and financial wellbeing. This is often a spouse or partner. Friends or roommates should not be considered a co-adopter.
(8a) Co-Adopter Information:*
(9) Please list the dog(s) you are interested in adopting.*
(10) Why are you interested in this dog(s)?*
(11) Are there any additional adults in your home?*

YesNo
(11a) Please list all additional adults in your home excluding yourself and any co-adopter listed above:*
(12) Are all adults in the home aware and in agreement of adopting a new dog?*

YesNo
(13) Would you consider yourself a head of the household/decision maker?*

YesNo
(13a) Who would you consider the head of the household/decision maker?*
(14) Are there any children in the home?*

YesNo
(14a) Information about all children in the home:*
(15) How long have you been looking to adopt a dog?*
(16) Why are you looking to adopt a dog? Select all that apply.*

Companion for selfCompanion for a childCompanion for another household memberCompanion for another petGiftGuard Dog / ProtectionTo breedHuntingOther
(17) Who will be responsible for the general care of this adopted dog? (Including feeding, walking, grooming, clean up.) Select all that apply.*

MyselfHousehold MemberChildRoommateOther
(18) Do you live in a:*

Single Family ResidenceMulti-Family Residence (Apartment, Condo, Townhome)
(19) Do you:*

RentOwn
(19a) Please provide your landlord's name, email, and phone number.*
(20) Do the rules for your City, Rental Agreement (if applicable), and/or HOA (if applicable) allow you to have additional animals in your residence?*

YesNoUnsure
(21) How long have you lived at this address?*

More than 2 yearsLess than 2 years
(21a) Please provide the address for your previous residence.*
(22) Finding housing can be challenging if you have pets. Not all moves are expected/planned. Are you aware that there can be challenges when searching for housing when you have pets.*

YesNo
(23) Do any household members have any allergies to any animals?*

YesNo
(23a) Please provide more information about your household member's allergies:*
(24) Are you currently employed?*

YesNoRetired
(24a) Employment Information:*
(24b) Lulu's Locker is unable to financially support animals after adoption. Do you have the financial means to support a new dog including daily expenses (food/routine vet care) and unexpected expenses (emergency vet care)?*
(25) Have you ever applied to adopt or foster a pet from any rescue or shelter including Lulu's Locker Rescue?*

YesNo
(25a) Please share more about those applications:*
(26) Have you ever had to rehome, relinquish, return, or give away any animal in the past?*

YesNo
(26a) Please provide information about the circumstances that required you to find a new home for your pet(s):*
(27) Which of the following situations would cause you to consider returning your adopted dog*

Job Loss, Financial ChangeNew ChildrenRelationship ChangesChanges in Adopter/Co-Adopter HealthMovingAllergiesSheddingHousetraining IssuesDoes not get along with other petsVet Expenses or Medical NeedsBehavioral IssuesNone of the AboveOther
(28) Dogs regularly have a lifespan of 15 years. Considering the age of the dog(s) you are interested in adopting, have you considered how your life/living situation may change over the dog's lifespan? Are you able to commit to care for this animal throughout its entire life?*
(29) Life is unpredictable. If your health were to fail or you were to become unable to care for your animal(s) for any reason what plans are in place to care for your pets both temporarily and permanently?*

(30) What expenses are you prepared and able to provide for? *

Rows	Yes	No	Unsure
Food
Treats
Routine Veterinary Care (Yearly Exams, Vaccinations)
Emergency Veterinary Care (Expect $1000, minimum)
Ongoing Veterinary Care (Allergies, Joint Problems, Ear Infections, etc)
Toys & Bedding
Boarding/Vacation Care
Grooming
Monthly Heartworm Preventative

(31) What reading/research/steps have you taken to prepare for a new dog?*
(32) What characteristics are important to you?*

Good with all dogsGood with some dogsGood with all catsGood with some catsGood with childrenGood with strangersHousebrokenMellow/CalmEnergetic/PlayfulOther
(33) Are there any pets currently living in your home?*

YesNo
(33a) Please provide details all pets currently living with you:*
(34) Are there any pets you have owned in the past 5 years that no longer live with you (including deceased pets)?*

YesNo
(34a) Please provide the details for all pets no longer living with you (past 5 years):*
(33b/34b) Please list all Veterinarians you have used in the past 5 years:*
(33c) How do you plan to introduce your new dog to any current pets?*
(35) If you have never owned any pets: have there ever been pets that you lived with or helped care for? If yes, feel welcome to provide details.*
If you have previously owned pets and they are listed above, or you have never helped care for a pet please type N/A.
(36) What expectations, if any, do you have of your newly adopted dog?*
(37) What do you think are the most important responsibilities of being a dog/pet owner?*
(38) How many hours will your adopted dog be left alone each day? (ie: Workday)
(39) When no one is home, where will your adopted dog be kept?
(40) Do you plan to crate train?*

YesNoIf Necesary/HelpfulOther
(41) How do you anticipate caring for your dog while you are traveling?*
(42) How much time will your adopted dog spend:*
(43) What outside space will be available for your adopted dog:*

Fully Fenced YardUnfenced YardOutdoor KennelChain or Tie-OutLeash WalkingOff Leash WalkingDog ParkDog will not go outsideOther
(43a) Please describe the fence material and height of your fence:*
(44) The adoption process and changing of a dog's environment can cause a dog to have accidents or personality/behavior changes. What steps are you prepared to take to deal with any behavioral issues that arise?*
(45) Are you willing to hire a trainer at your own expense to deal with any behavioral issues whether they were known or unknown at the time of adoption?*
(46) Please list two personal references that you are NOT related to, and do NOT live with you. *
(47) How did you hear about Lulu's Locker Rescue?*

Petfinder.comAdoptAPet.comFacebookInstagramFriend or Family MemberLulu's Locker Rescue WebsiteOther
(48) You may use this space to provide any additional information you care to share:
This question is optional.
(49) Do you or the Co-Adopter have any preferred names, pronouns, or name pronunciations that you would like us to be aware of?
This question is optional.
(50) Please check that you understand and agree to each of the following*

The information provided in this application is true to the best of my knowledge.Lying or omitting information are grounds for immediate denial.I understand that Lulu's Locker rescue reserves the right to refuse any adoption for any reason.
Form Submission:

If your form has been submit you will be taken to a new page and you will receive an email with a copy of your answers. If you aren't sure if your form is being submit, please save your form and contact us: luluslocker@gmail.com.
HIDDEN Email
luluslockeradoptions@gmail.com
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Dog Adoption Application

Please Read - Saving Your Progress:

Form Submission: