Adoption Application
1. Name of dog you are applying for:
2. Explain why you have chosen this particular dog
3. Describe how you see this dog fitting into your life
4. Is this your first dog?
5. Your full name (first and last)
6. Name of spouse/partner
7. FULL ADDRESS (street, town, province, postal code)
8. Home Phone
9. Mobile Phone
10. Work Phone
11. Email address
12. Profession and Employer
13. Profession and Employer of Spouse/Partner
14. Do you own or rent your residence?
15. If renting are pets allowed?
Yes
No
16. If renting, name and phone number of your landlord (they will be contacted)
17. Briefly describe your neighborhood & style of home
18. Who will be the primary caretaker of your pet? Explain.
19. How many people live in your home? INCLUDE AGE, NAME, RELATIONSHIP of each.
20. Do they have experience handling animals? Explain.
21. Do children regularly visit your home? If yes include ages.
22. In the absence of the primary caretaker, who will take care of the pet? Please understand that we may be calling this person to verify that they will be looking after the pet.
23. During long vacations, or unexpected or extended periods where you may be required to leave your pet, how will you provide care?
24. Please describe your family’s activity level (moderate, active, laid-back)
25. Please describe in detail, how you plan to exercise this dog?
26. Please describe how you plan to provide this dog with access to the outdoors for bodily functions (ex. fenced yard, walks, tether).
27 Are you looking for a dog that can be exercised off leash in an uncontained area?
28. How long will this dog be left alone on an average day?
29. Where will this dog be kept at night?
30. Where will this dog be kept during the day?
31. Where will this dog be kept while home alone?
32. What type/brand of food do you intend to feed your new dog?
33. Detailed description: breed, age, sex, spay, neuter, vaccinated PREVIOUS Pet #1
Previous Pet #2
Previous Pet #3
Previous Pet #4
Additional Pets
34. CURRENT Pet #1
Current Pet #2
Current Pet #3
Current Pet #4
Additional Pets
35. If you currently have a dog(s), has your dog ever shown any aggression or reactivity toward another dog? ie lunging, growling, biting, barking? Please elaborate how your dog reacts when encountering other dogs.
36. If you currently have a dog(s) in your home, how do you socialize them with other dogs? ie: dog parks, walks with friends and their dogs, etc. Please indicate how often you socialize your dog with other dogs.
37. If you currently have a dog(s) in your home, how does your dog react when another dog comes into the yard and into your home? How does your dog respond to sharing toys, being fed, receiving treats with another dog in your home?
38. Describe how you have trained dogs in the past.
39. Are you willing to enrol in a POSITIVE training program if required by MMDR?
Yes
No
40. If a behavioural problem arises, what steps will you take to work on it?
41. Should you or a member of your household develop an allergy to this dog what will you do?
42. How often do you plan to visit the veterinarian? How much are you willing to spend to provide the necessary care for this dog?
43. Have you ever adopted from any rescue/humane organization? If yes explain.
44. Have you ever sold, surrendered or given any of your animals away for any reason? If yes, please explain the reason(s):
45. What do you think are the most important responsibilities in having a companion animal?
46. What steps are you willing to take to ensure this dog adapts and thrives in a new environment?
47. Rescued dogs have sometimes been in neglectful and/or abusive situations and therefore may experience difficulty making the transition to a new home. Are you willing to be patient while your dog adjusts to its new home?
48. How long do you feel an animal should be given for an adjustment period?
49.Are you willing to take the time to work with a pet on housetraining or other issues, should the need arise?
50.Do you understand and accept that changing an animal’s environment may cause the animal to have accidents, especially in the early days of adoption?
51. What do you consider a good and valid reason for giving up a pet?
52. Could your family conceivably be forced to relocate in the future? How would this dog factor into the process?
53. Could your family grow in the future? (children, grandchildren, puppies, cat) Explain.
54. How will you manage your dog with any new family members?
55. Have you made arrangements for the care of your pets in the event of your death? Explain.
56. Have you ever been investigated or convicted in relation to animal abuse or neglect?
Yes
No
57. Have you had an adoption application turned down by an animal placement organization? If yes explain.
Veterinary Reference (clinic name, phone number and address)
Reference #1 Non-family member only (name, phone, email, relationship to you)
Reference #2 Non-family member only (name, phone, email, relationship to you)
If you have a groomer please provide name and contact info:
If you have used a trainer in the past please provide name and contact info:
If you use a dog daycare please provide name and contact info:
Please list any concerns or final questions here:
Applicants Full Name
First Name
Last Name
Date:
Submit
Should be Empty: