Dog Adoption Application Form

Dog Adoption Application Form

Please fill out this detailed form to help us understand your suitability for adopting a dog.
Applicant Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Do you live in a house or apartment?*

HouseApartmentOther
Do you own or rent your residence?*

OwnRentOther
If renting, do you have permission from your landlord to have a dog?

YesNoNot Applicable
What is your occupation? (Please include est. yearly gross income)
Do you have any pets? If Yes, Please list the types and number of pets you currently own.
How many people live in your household?*
Are there children in the household?*

YesNo
If yes, please specify their ages
Do all members of the household agree to adopt a dog?*

YesNo
What type of dog are you interested in adopting?*
Why do you want to adopt a dog?*
Describe your experience with dogs*
How many hours per day will the dog be left alone?*
Where will the dog be kept during the day?*

IndoorsOutdoorsBoth indoors and outdoors
Where will the dog sleep at night?*

IndoorsOutdoorsBoth indoors and outdoors
Do you have a fenced yard?*

YesNo
Who will be responsible for the dog's care?*
Are you willing to provide veterinary care, including vaccinations and emergency care?*

YesNo
Do you have a regular veterinarian? If yes, please provide their contact information
Have you ever surrendered a pet to a shelter or rescue? If yes, please explain*
Where will your dog stay should you go on vacation, in case of emergency etc?
Under what circumstances would you consider giving up/ surrenedering your dog? (please check all that apply)

Behavior ProblemsLarge vet billsJob change/lossMovingIncontinenceDog develops chronic illness/ disabilityDog does not meet my expectationsDog nips/bites kidsDivorce/ SeparationOld ageNone of the aboveOther
Please provide any additional information you think is relevant
Do we currently have a dog in our program that you are interested in? If so, who?
Applicant Signature*

Clear
Date*

MonthDayYear
Date
Application Fee*

prevnext( X )
USDBy submitting this application, you acknowledge that it does not guarantee approval for adoption through Quinn’s K-9 Services LLC. Your application will be reviewed by our team, and you will be contacted regarding next steps. If you are applying to be added to our waitlist while we work to find your perfect match, please feel free to email us at quinnsk9services@gmail.com with any additional questions. Thank you for your interest and support!
Payment Methods

Choose from one of the PayPal options to make your payment.
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