Adoption Application Form

Dog Adoption Application
Which dog(s) are you interested in?
Full Name

First NameLast Name
Cell Phone Number

Area CodePhone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you planning on moving within the next 6 months?
If yes, what are your plans for your pets if you move?
Name of Employer & Title:
Best time to contact you throughout the day?
Are you 18 years of age or older?
Do you rent or own your home?
Type of Dwelling:
Name and age of ALL occupants in household (including yourself):
Do you have children, or will children be visiting the household frequently?
What is your reason for wanting to adopt a dog?
How many total hours will your new pet be left alone during the day, and where will they stay?
Do you have a fenced yard?
If yes, which type of fence?
If yes, how tall is your fence?:
Do you have locks and/or latches on all your gates?
Who will have main responsibility for the care of your new pet?
How many pets currently live in the home?
List each pet including breed, age and gender:
Have you ever lost or given away a pet?
If you currently own a dog or cat, how does he/she react to new pets?
Are your present pets up-to-date on their annual vaccines?
If no, please explain:
Are your current pets spayed or neutered?
If no, please explain.
How much are you financially prepared to spend for routine/emergency medical care, licensing, etc?
What plans do you have for your new pet when you are on vacation?
Will you provide your dog with monthly heart worm/flea/tick prevention?
Who is your current or most recent veterinarian? Please provide their NAME and PHONE NUMBER:
If your dog displays behavioral problems (such as jumping on people,excessive barking, potty accidents, etc.) how would you go about correcting the behavior?
If other, please explain:
What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?
If other, please explain:
Are you prepared to commit to a dog for 10-15 years?
Have you ever adopted or tried to adopt a pet from us before? If yes, fill out info below.
Where will your dog spend most of his/her time?
Where will your dog sleep?
Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.
Reference #1
First and Last Name & Relationship to Self
Reference # 1 Phone Number

Area CodePhone Number
Reference #2
First and Last Name & Relationship to Self
Reference #2 Phone Number

Area CodePhone Number
If there is anything else you think we should know, please note it here.
Please remember, it may take approximately 5 to 7 business days for us to get back to you.
We appreciate your interest in adopting a dog from PPRO, and we look forward to speaking with you!
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Dog Adoption Application

Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.

Please remember, it may take approximately 5 to 7 business days for us to get back to you.

We appreciate your interest in adopting a dog from PPRO, and we look forward to speaking with you!