CHICO!
Applicant(s) Name(s):
*
Applicant(s) age(s):
*
Street Address:
*
City, State, Zip
*
Primary Phone:
*
Format: (000) 000-0000.
Secondary Phone:
Format: (000) 000-0000.
E-mail:
*
Employer:
Residence Type:
*
House
Apartment
Condo
Mobile Home
Farm
Other
If you answered "other" above, please describe:
Do you...
*
Own your own home
Rent
Live in a family home owned by relatives.
If renting, this landlord has given me permission for pet ownership.
Yes
No
What restrictions are there for dog ownership in your apartment, HOA, or subdivision?
*
Number of pets
Size or weight restrictions
Breed restrictions
None
My home has a fully-fenced yard.
*
Yes
No
Fence height and material:
On the property of my home, I have:
Underground fence
Kennel
Dog Run
HOUSEHOLD INFO
All members of my household are in agreement with this adoption.
*
Yes
No
Don't Know
The primary caretaker of the pet will be:
*
Number of adults living in my home and their relationship to me:
*
Number of children in my home and their ages:
*
The children in my home have experience with dogs or other animals.
Yes
No
Other
If you answered "other" above, please describe.
In my home, someone has allergies to dogs or asthma,
*
Yes
No
Other
If you answered "yes" above, please describe how allergies/asthma are managed.
Current/Past Pet Information
Please list all pets who CURRENTLY live in your household.
Include name, type/breed, age, gender, alteration status, how long owned, indoor/outdoor.
Include name, type/breed, how long owned, what happened to the pet.
In the past, I have taken a pet to the shelter or given an animal away.
*
Yes
No
If yes, please explain the circumstances.
I have previously adopted from a shelter or animal welfare group.
Yes
No
If yes, please list the name of the group.
I have previously managed a dog with reactive tendencies toward other dogs on leash
*
Yes
No
If yes, please explain the circumstances and how you managed your dog's behavior.
The name and phone number of my current and/or previous veterinarian or vet clinic:
New Pet Information
I am willing to provide my new dog with at least this much time to adjust the new home environment:
*
I am aware that a new environment is stressful for a dog and acknowledge they may exhibit unexpected behaviors:
*
Yes
No
I understand that vet costs for the dog may amount to hundreds of dollars per year:
*
Yes
No
I understand that a dog can be a commitment that lasts up to 18 years.
*
Yes
No
I have successful experience with house-training a dog or puppy.
*
Yes
No
This is my plan to let my dog relieve itself:
*
If/when the dog has an "accident" in my home, this is my plan to address it:
*
I have an awareness of crate training.
*
Yes
No
The maximum number of hours each day my new pet will be home alone:
*
When/if I work full-time or am gone more than 4-5 hours at a time, this is my plan for the dog:
*
Location where my new pet will sleep at night:
*
My exercise and activity plans for my dog:
*
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
Submit
Should be Empty: