Adoption Application
NAME OF DOG YOU ARE APPLYING FOR?
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Applicant's Name
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First Name
Last Name
Applicant's Address
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Street Address
Street Address Line 2
City
State
Zip Code
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Applicant's Age
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Applicant's Employer
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Spouse/Partner's Name - if applicable
First Name
Last Name
Spouse/Partner's Age
Spouse/Partner's Employer
Number of adults in home
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Number of children in home
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If no children in the home please put "0"
Age(s) of children in home
If no children in the home, leave blank
Does everyone in your household approve of this adoption?
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Yes
No
Tell us about your home. Choose all that apply.
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Single family home
Multiple unit condo
Single unit condo
Apartment
Townhouse
Direct access
Hallway access
Do you live in a community with a Homeowner's Association (HOA)?
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Yes
No
IF YES: please provide HOA contact information
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(Name/phone/or email of HOA contact, website with policy) or documentation of any pet or breed restrictions. This is required to ensure there are no conflicts regarding your ability to adopt and keep a pet in your home. Including this information will speed up the approval process. pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
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Do you own or rent your home?
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Own
Rent
Lease
IF YOU RENT/LEASE - Landlord's information
Landlord's Name
Address
City/State
Zip Code
Phone Number/email
Landlord's Phone Number
Please enter a valid phone number.
IF YOU RENT/LEASE - Are there pet or breed restrictions in your rental/lease agreement?
Yes
No
IF YES: please provide documentation of any pet or breed restrictions from your rental/lease contract
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This is required to ensure there are no conflicts regarding your ability to adopt and keep a pet in your home. Including this information will speed up the approval process. pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
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Veterinarian - if you have had no pets in the last 3 years, you may leave blank. Please contact your vet and give permission for us to talk with them. Not providing veterinarian information/permission to speak with them may result in denial of application.
Name
Address
City
State
Zip Code
Veterinarian's Phone Number
Please enter a valid phone number.
How many dogs do you currently have?
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List name/breed/age/sex of current dogs
If no current dogs, leave blank
List all prior dogs you've had within the last 10 years. Include why you no longer have them or cause of death if applicable.
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If this is your first dog, please note that above.
How many cats do you currently have?
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Are your current dogs/cats spayed/neutered?
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Yes. Everyone is spayed or neutered
No. None are spayed or neutered
No. Not everyone is spayed or neutered due to my veterinarian's recommendation.
I have no dogs or cats currently.
Are your dog(s)/cat(s) current on core vaccinations
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Yes
No
No dogs/cats
Don't know
Are/were your dog(s)/cat(s) current on core vaccinations (Rabies, DHLPP/DA2PP) and HW/flea/tick prevention? (Choose all that apply)
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Yes
No
Don't know
Some are not - due to veterinarian recommendations
Current on core vaccinations but not HW/flea/tick prevention
No current dogs/cats but they were all current.
No current dogs/cats but they were not current.
What brand of heartworm prevention do/did you use?
What brand of flea/tick prevention do/did you use?
In order to speed up verification of vetting records, you may upload vetting files. Include: spay/neuter verification, current vaccination records (Rabies and DHLPP or DA2PP) and proof of current prescription or recent purchase of HW/flea/tick prevention for each dog you currently have.
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Drag and drop files here
Choose a file
pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
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Have you ever surrendered or given away a dog?
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Yes
No
IF YES, please explain in detail here:
Is your yard fenced?
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Yes
No
IF YES, what type of fencing do you have? Check all that apply.
Physical Fence - fully fenced
Physical Fence - partially fenced
Invisible/underground Fence
Halo or other WIFI type virtual fence
Other
IF NO - please describe how you will keep your dog safe.
How do you plan on exercising your dog?
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How do you plan on socializing your dog?
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Why are you interested in adopting this dog?
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Tell us how you plan on training a new dog:
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How do you feel about shock/vibration collar training?
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Do any members of your family have animal related allergies? Choose all that apply
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Yes
No
Dog
Cat
Applicant
Family member within the house
Family member who visits
Controlled with medication
Not severe enough for medication
Who will be primarily responsible for caring for a dog? Check all that apply
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Applicant
Spouse/partner
Age appropriate children with parental guidance
What are the working hours of the adults in the household?
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Where will the dog be kept during the day?
Where will the dog be kept during the night?
How many hours will the dog be left a day without human companionship?
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How do you feel about crate training and crating your new dog when unsupervised? (choose all that apply)
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Agree with crate training
Disagree with crate training
Have no experience with crate training
Have no opinion on crate training
Am willing to utilize a crate
Am not interested in utilizing a crate
Where will the dog be kept when left alone?
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What food do you plan on feeding?
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How will you housetrain your dog?
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Please describe your lifestyle.
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What characteristics are you looking for in a dog?
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What characteristics do you find undesirable in a dog?
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Would you adopt a senior dog?
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Yes
No
Depends on the dog
Would you accept a dog that has been abused?
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Yes
No
Depends on the dog and what type of abuse there was
Are you willing to give a new dog at least 2 months to adjust and bond with your family?
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Yes
No
Are you willing to hire a trainer as opposed to returning the dog if behaviors arise?
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Yes
No
Describe in detail how you will manage unwanted behavior:
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This area is open for you to add any additional information you feel will help us make a decision as to why this dog will fit into your lifestyle
Have you (or any member of your household) ever been charged with animal abuse/neglect?
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Yes
No
Have you (or any member of your household) ever been charged with domestic violence?
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Yes
No
Have you (or any member of your household) ever been charged with child abuse/neglect/endangering?
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Yes
No
Personal reference - family, coworker or friend
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First Name
Last Name
Personal Reference's email
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example@example.com
By signing electronically below you are agreeing that the information provided is correct.
*
Please type your name.
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