Dog Adoption Form

How did you find out about Us

I’m interested in the dog named

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Number

Please enter a valid phone number.Format: (000) 000-0000.

Work Number

Please enter a valid phone number.Format: (000) 000-0000.

Alternate Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Have you ever owned a dog

If yes, what happened to your dog

Do you own any other pets

If yes, please list Breed, age, and species in your home

Is your your dog (past or present) spayed or neutered

Is your dog (past or present) up to date on vaccinesp

Is your dog (past or present) on heartworm prevention

If yes, what is the name of the heartworm prevention

Is anyone in your family allergic to dogs

What traits are you looking for in a dog

Is everyone in agreement with this adoption

How many people reside in your home?

Please list the ages of the people that reside in your home, including yourself.

Do you rent or own your home

If you rent, may we contact your landlord to verify dogs allowed

If yes, please provide name and number of your landlord

Do you have a fenced yard

Approximate height of your fence and description of your fence. (Wood of cyclone)

Have you checked your fence for escape routes?

How will you exercise your new pet

How many hours will your pet be alone

Where will the pet stay when it’s alone

What steps will you take to complete house training your pet?

Where will your pet sleep at be night?

Faced with an emergency, who will care for your pet?

If you travel and can’t take your pet, who will care for your pet?

How would you handle a conflict between your new pet and a family member?

If your circumstances change (death, marriage or divorce)

Please list the name of your veterinarian?

Phone Number of veterinarian?

Please enter a valid phone number.Format: (000) 000-0000.

Name the account is under and pet’s name

Name of personal reference

First NameLast Name

Phone Number of personnel reference

Please enter a valid phone number.Format: (000) 000-0000.

I understand that A New Dawn Pet Adoption tries to find the best home for every pet. I understand that someone may be a better fit for the dog I’m applying to adopt, this means I mày be denied.