Dog Adoption/Foster Application & Contract
Dog of Interest
Name, description or preferences
Which of the following are you applying for?
Adoption
Short Term Foster only
Long term Foster only
Foster to Adopt
Applicant Information
Applicant's Legal Name
*
First and Last Name
Street Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Applicant's Email
Home & Household Information
Please verify with your landlord or local government ordinances that the breed you are interested in is permitted on property. Breeds such as pit bulls or bulldogs may not be.
Home Information (What type of home do you live in?)
*
House
Mobile Home
Apartment
Duplex
Other
Home Ownership Information
*
I Own my Home
I Rent my Home
Other
The Home has the following (Please select all that apply):
*
A Fenced Yard
No Fenced Yard
No Yard
An Outside Kennel
A Dog Door
Wireless fence system
Other
List all adults your dog will be living with, including yourself
Ages of children in the home or who visit frequently
*
Non-Applicable
Infant
1-3years
4-7 years
8-12 years
13-17 years
Did your entire family agree on the adoption or foster of this dog?
*
Yes
No
General Care
Do you want this dog to be:
*
Inside pet only
Outside pet only
Both an Inside and Outside Pet
Please tell us why you would like to adopt a dog:
*
Household Pets
Do you have any other pets now? Please include inside and outside pets, including any livestock
*
Yes
No
Plan to adopt more
List all pets below (Type of animal, breed, age, and if dogs indicate if spayed/neutered)
Have you owned pets in the past?
*
Yes
No
List Past Pets below (Type/Dog, Cat, Bird, Etc & Breed)
Health
Veterinary Name or Office
*
Veterinary Phone
*
Do you feel you are financially capable of paying for routine veterinary care?
*
Yes
No
Additional Information
Additional Information for consideration (if any)
Adoption/Foster Terms of Acceptance
(Upon Adoption or Foster approval)
Acknowledgment of Applicant/Signer
*
✔I/We hereby agree to care for this dog humanely, (including providing adequate food, water, shelter and attention).,
✔I/We agree that said dog shall be maintained in an adequate enclosed area or on leash at all times. Dog shall not be allowed to roam at will.,
✔If said dog becomes lost or stolen, I/We agree to notify the pound immediately.,
✔I/We agree that said dog will not be used for any illegal purposes.,
✔I/We understand that the Crockett County Pound makes no guarantees or warranties regarding the health or temperament of this dog.
By signing below, I warrant the truthfulness of the information provided & certify that all information is true. I understand that false information may result in nullifying this adoption at any time. Electronic Signature
*
Type Legal Name:
Date:
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