Lothbrok Ranch Canine Rescue Adoption Application

Adoption Application
This questionnaire is designed to help Lothbrok Ranch and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Lothbrok Ranch reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!
Applicant Information
Name of the dog you are interested in:*
Your full name:*
Your age:*
Street Address:*
City/Town, Province, Postal Code*
Best Phone Number To Reach You:
Format: (000) 000-0000.
E-mail:
Character reference and phone number:
YesNo
Household Information
YesNoDon't Know
Who will be the pet's primary caregiver?*
HouseApartmentCondoMobile HomeOther
RuralWithin Town Limits
OwnRent
If rent, provide name and phone number of landlord:
YesNo
Number of petsSize or weight restrictionsBreed restrictionsNone
YesNo
Underground fenceKennelDog Run
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?
YesNo
YesNo
Current/Previous Pet Information
List any pets you own, their breed, and their ages
How many of these pets are spayed/neutered?
YesNo
If yes, what group?
YesNo
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:
New Pet Information
YesNo
If the dog has an "accident" in your home, what type of correction do you plan to use?*
How many hours each day will your new dog be home alone?*
Where will your new dog sleep at night?*
How will you supervise the dog's outdoor activity?*
Where will your new dog stay when nobody is home?*
What length of time will you allow your new dog to adjust to his new home?*
YesNo
YesNo
YesNo
What circumstances would lead you to give up your new dog?*
If you had to give up your dog, what would you do with him/her?*
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
Signature
Should be Empty:

Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information