Puppy Adoption Application
Thank you for your interest in a Canines for Change puppy! Please complete this application in full. Submission does not guarantee approval. Our priority is placing each puppy in a home that aligns with our standards, values, and lifelong commitment expectations.
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Adoption Fee Acknowledgement
I understand the adoption fee is $2,000. Our adoption fee helps ensure that our puppies are going to committed, responsible homes while directly supporting the programs that make our work possible. As a 501(c)(3) non-profit, 100% of the proceeds go directly back into our programs.
*
Yes
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Applicant Information
Name
*
First Name
Last Name
Additional Responsible Adult (If Applicable)
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Occupation(s)
*
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Household Information
Type of Residence
*
Please Select
Single Family Home
Condo
Apartment
Farm
Other
If other, please explain.
Do you
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Rent Your Residence
Own Your Residence
If renting, landlord's name and phone number:
How long have you lived at your current residence?
*
How many adults live in the home?
*
How many children live in the home? Please include the children's ages.
*
Does anyone in the household have dog allergies?
*
Yes
No
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Lifestyle & Home Environment
Why are you interested in a Canines for Change puppy?
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What activities do you envision including your puppy in?
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Companion Pet
Running/Hiking
Family Activities
Therapy Work (Not Facility Dog Certification)
Other
How many hours per day will the puppy be alone?
*
Do you have a fenced yard?
*
Yes
No
If yes, describe the type and height.
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Dog Ownership & Experience
Have you previously owned a dog?
*
Yes
No
If yes, list breeds and what happened to them.
Do you currently have pets?
*
Yes
No
If yes, list species, breed, age, and temperament.
Are current pets vaccinated and on heartworm prevention?
*
Yes
No
N/A
Have you ever rehomed or surrendered a pet?
*
Yes
No
If yes, please explain.
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Training Commitment
Our puppies receive early neurological stimulation, structured socialization, and foundational exposure before placement. Continued training is essential. Each puppy includes one complimentary five-week public obedience course through Canines for Change.
If you live locally, are you willing to attend and complete this course?
*
Yes
No
Are you willing to seek professional training support if needed?
*
Yes
No
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Veterinary & Financial Responsibility
Are you financially prepared for routine veterinary care and emergencies?
*
Yes
No
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Placement Preferences
Gender Preference
*
Please Select
Male
Female
No Preference
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Acknowledgment & Understanding
I understand that this puppy is being placed as a companion pet and is not part of our facility or service dog program and does not come with such training.
*
Yes
I understand that submission of this application does not guarantee approval.
*
Yes
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Personal Reference
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Relationship
*
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Certification
I certify that all information provided is true and complete to the best of my knowledge.
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