DOG ADOPTION APPLICATION
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DOG ADOPTION APPLICATION
Applicant name
First Name
Last Name
Co-applicant name
First Name
Last Name
Adopt or Foster?
Description of dog
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email address
example@example.com
Confirm Email address
example@example.com
Employer Name and Address
Occupation and Length of time with employer?
What type of home do you live in (i.e. apartment, duplex, single family home, farm)?
Own or Rent Home?
What do you think are the most important responsibilities in owning a dog?
Have you submitted an application with another organization for a dog at this time?
Have you ever had an application declined for adoption of an animal from an animal welfare group/facility? If yes, please explain.
How much training would you be prepared to do with a dog?
Are you willing to take the time to housebreak a dog and do you understand that changing a dog’s environment may cause the dog to have accidents?
If a behavioral issue arises, what steps will you take to work on it?
For whom are you adopting the dog?
How many adults live in your home (please include all names, ages and relationships and how they will be involved with the dog)?
Describe the kinds of personal situations where you might have to return a dog (i.e. job change, birth of children, move, marital change, etc.)
Are there children in the household? If yes, what are their ages?
Who will be primarily responsible for feeding and taking the dog outside?
Who will care for the dog in the absence of the primary caretaker?
Will you take the dog to obedience training? Is so, where?
Would you be willing to obtain an appropriately sized open wire crate?
Describe the pets you currently own (Name, age, spayed/neutered, preventative medicines, indoors or out). What year did you get the pet(s)? How did you acquire the pet(s)? Further comments about the pet(s)?
Describe all of the pets you have owned in the past 10 years and cause of death or where the pet is now.
List each veterinarian where your pets have received care over the last 5 years (Phone number(s) must be provided)
Have you considered the extra expenses that will come with having a dog, including vet care, food, supplies, equipment, toys, training and boarding?
What is the size of your lot? Do you have a fenced yard? If yes, does it completely enclose the yard? Kind of fence? Does it have holes or gaps? How high is it? Is the fence attached to the home? Does the fence belong to you or your neighbor?
If you have no fence, do you plan to install one? If yes, when and what kind?
Described the circumstances in which you would walk/ exercise a dog OFF leash.
How often will you exercise the dog and approximately how long?
How many hours a day will the dog be left unattended?
When you are home, where will the dog be kept?
Where will the dog sleep?
When nobody is home, where will the dog stay?
How often do you travel?
What will you do with the dog when you travel?
If you have to move, what will you do with the dog?
Are you in the military?
Is everyone in your family in agreement about adopting a dog?
How far would you be willing to travel to meet a potential dog?
Would you be willing to have a rescue representative conduct an onsite visit?
Are you aware that all adopted dogs must be spayed/neutered?
Why do you want to adopt a rescued dog?
Please list name and phone number of Veterinarian you use (by entering this information you are giving us permission to speak to your vet)
Reference #1 Please list full name, address, phone number and relationship
Reference #2 Please list full name, address, phone number and relationship
Reference #3 Please list full name, address, phone number and relationship
Anything you would like to add?
By submitting this application, you acknowledge that if, for any reason, you need the dog to be rehomed, you will be expected to keep the dog until a new adopter or foster can be found. Agree or Disagree?
By submitting this application, you acknowledge the application will be reviewed and processed by members of the rescue. Applicant(s) grants permission for listed veterinarian to release information to the rescue member upon request. Rescue member may utilize information submitted to do a DMV and criminal background check. References are granted permission to speak with a rescue member who is completing a background check for the application to adopt a rescue dog. Agree or disagree?
Submit
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