Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of birth
Phone Number
Please enter a valid phone number.
Email
example@example.com
We kindly ask that if you are not ready to bring a dog/animal home and/or have vacations or other commitments planned in the foreseeable future, please wait to apply until your schedule is free. We cannot hold dogs to accommodate your schedule. You will also have to read and sign the 3-3-3 Rules before taking home a new rescue pet.
Which dog are you interested in (name):
If the dog you are interested in is not listed, or if you are interested in multiple dogs, please enter their name(s) here:
How many people reside in your household?
Please list household members by gender and age:
Are you employed outside the home?
List your current pets, species/gender/spayed/neutered/UTD on vaccines:
We like to help you to find the perfect match for you. Please tell us a little bit about your lifestyle. How would you best describe yourself?
What is your ideal dog relationship?
Have you ever given up a pet? If yes, please explain:
Will the dog be kept inside or outside?
How much time will the dog spend alone during the day?
Where will the dog be kept when you are home?
Where will the dog sleep?
Where will the dog be kept when you are not home?
In what type of home do you live?
Do you own or rent your home?
If you rent, have you received the approval of your landlord to have a dog?
Is your yard fenced? What is the height of the fence?
What type of fence? We do NOT approve of invisible fences! Those are cruel and abuse to the animals!
Please list three references (not family members). Please provide their name, phone number AND email address:
Do you have a criminal record (in regards to animals)?
I certify that the information entered on this application is true. Enter your name and date
Submit
Should be Empty: