ADOPTION APPLICATION

ADOPTION APPLICATION
Pet Preferences
Name of the pet you are applying for*
Animal type*

DogCatOther
Full Name*
Todays Date*

MonthDayYear
Street address*
City*
State*
Zip Code*
Email*
example@example.com
Phone Number*
Format: (000) 000-0000.
Date of Birth*

MonthDayYear
Employment
What is your current occupation or status?*

EmployedVolunteerUnemployedOther
Employer name*
Employer number*
Household Information
Do you rent or own?*

RentOwn
Type of residence*

HouseCondo/TownhouseApartmentMobile Home
If renting, please provide landlord name & phone*
Does your landlord allow pets?*

YesNo
Number of adults in the home*
Are there children in the home?*

YesNo
If yes, please list number and ages of children*
Do the children have experience with pets?*

YesNo
Is anyone in the home allergic to pets?*

YesNo
Do you expect to move in the next few months?*

YesNo
Do you have a private and fenced yard?*

YesNo
Is someone home during the day?*

YesNo
If not, how many hours will the dog be home alone?*
Where will the dog stay while you are away or at work?*

Crate (indoors)Inside- free roamingOutside (in yard or doghouse)Access to indoors and outdoors via a doogie doorDoggie daycareOther
How will you exercise with your new pet?*
Walks, hikes, doggie park, etc.
Do you have previous experience with housetraining?*

YesNo
Do you have experience with dog obedience training?*

YesNo
If yes, what kind of training was it?*
Where will the dog stay if you are away from home for vacation or travel?*

House sitter will care for themKennel/Doggie DaycareFriend/Relative's House
Current Pets & History
Do you currently have any other pets in the home?*

YesNo
Current pets*
Species and ages
Do they get along with other pets?*

YesNo
Are all the dogs in the home currently up to date on all vaccines?*

YesNo
Are all the dogs in the home currently spayed or neutered?*

YesNo
If not, please explain why*
Veterinary Information
Please provide your veterinarian's contact information.
Name*
Address*
Phone number*
Format: (000) 000-0000.
*Please note we will be calling your vet to check references.
Agreement Section
Do you agree to a home visit?*

YesNo
Do you agree to return the pet if unable to keep?*

YesNo
Do you understand adjustment needs and commit to care?*

YesNo
Do you agree that you can afford veterinary care for this pet-including vaccinations, physical exams, emergency visits, and dental care?*

YesNo
Final Acknowledgement*

I certify that all the above information is true and understand that providing false information may result in my application being declined.
Signature*
Date*

MonthDayYear
Today's date
Thank you for your interest in adopting a dog from Dulce Vida Rescue. Please be advised that filling out this application is not a guarantee of adoption. We reserve the right to refuse to adopt to any applicant for any reason.

We are unable to respond to any applications unless all questions are answered and veterinarian information has been provided.
Should be Empty:

ADOPTION APPLICATION

Pet Preferences

Employment

Household Information

Current Pets & History

Veterinary Information

Agreement Section