Dog Adoption Application

Animal you are interested in adopting

Applicant's First Name *

Last Name*

Street Address*

City*

State*

Apartment Number (if applicable)

Zip Code *

Phone Number*

Please use the following format 248-555-1212

Email Address*

Please enter correctly as this is the main way we will contact you

Alternate Phone Number

Please use the following format 248-555-1212

Are you interested in multiple animals or pairs? (list the name of additional animals of interest) *

Please use the following format 248-555-1212

How did you find out about us?

Have you applied anywhere else for a pet? *

Is this pet for you or someone else?*

What other pets do you own, please list their names, breeds, and ages? *

Are all of your pets spayed/neutered/fixed?*

How many pets have you owned in the last 5-10 years?*

What happened to them?*

Are your pets current on their vaccinations?*

Have you ever turned your dog or cat into a shelter? If yes, please explain?*

Veterinarian's Name & Phone Number*

If you have never owned a pet please tell us where you would go.

Have you ever had a pet euthanized? If yes, please explain:*

What preventative flea/tick/heartworm medication do you prefer?*

Were any of your pets obedience trained?*

Please check the main reason you plan to adopt a pet:*

Type a questionIf you answered "other" above, please explain here:*

Please describe in detail the pet you are looking for.*

Do you own or rent your home?*

Please select your current residence type.*

If you answered "other" above, please explain here:

How long have you lived at this address?*

If you rent, does your landlord and lease allow pets?*

Including yourself, how many people live in your household?*

Please list the ages & relationship of those who live in your home (including yourself).*

Is everyone in your household aware that you are planning to adopt a pet?

Does anyone in your household have allergies to dogs/cats?

Employment Status

If you chose "other" above, please explain:

On average, how many hours per day will your pet be left alone?*

How much do you think the annual medical bills will be for your pet?*

What would you do if the bills went over this amount?*

Will this pet be predominantly living inside, outside, or both?*

Please provide a description of this pet's living conditions.*

Do you have a completely fenced-in yard? If so, what kind of fence? *

If you answered "other" above, please explain:

If you do not have a fenced yard, how will you let the animal out?*

Are there times when the animal will be tied/chained up?*

If yes, when will they be tied/chained up?

Where will the animal sleep?*

If you answered "other" above, please explain:

Will the animal spend any time in the garage?*

If the animal will spend time in the garage, please explain when/why:

How will you handle housebreaking?*

How will you handle destructive behavior?*

Will you keep the animal up-to-date on vaccinations and heartworm preventative?*

If no, please explain:

Are you willing and able to exercise the dog on a regular basis?

If yes, what is the method of exercise?

If you answered "other" above, please explain:

Have you ever been convicted of abuse or neglect of a child or animal?*

If yes, please explain:

If you drive a pick up truck, would you allow the animal to ride in the back/bed?*

What arrangements will you make for the care of your pets in case of an emergency?*

If you answered "other" above, please explain:

What will you do with the animal when you go on vacation?*

If you answered "other" above, please explain:

For what reason(s) would you consider returning/giving up the animal?*

What would you do with your animal if you had to move? *

If you answered "other" above, please explain:

Are you willing to take responsibility for this animal for the next 10-20 years?*

If no, please explain:

Are you open to a special needs animal?*

Will you allow us to perform home checks?*

Please provide the name and phone number for a reference not related to you.

Please provide the name and phone number for a reference not related to you

Please provide the name and phone number for a reference

I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.