Adoption Application

Adoption Application
NAME OF DOG YOU ARE APPLYING FOR?*
Applicant's Name*

First NameLast Name
Applicant's Address*

Street Address

Street Address Line 2

CityState

Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Applicant's Age*
Applicant's Employer*
Spouse/Partner's Name - if applicable

First NameLast Name
Spouse/Partner's Age
Spouse/Partner's Employer
Number of adults in home*
Number of children in home*
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?*

YesNo
Tell us about your home. Choose all that apply.*

Single family homeMultiple unit condoSingle unit condoMobile HomeApartmentTownhouseDirect accessHallway accessOther
Do you live in a community with a Homeowner's Association (HOA)?*

YesNo
IF YES: please provide HOA contact information

(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
Cancelof
Do you own or rent your home?*

OwnRentLease
IF YOU RENT/LEASE - Landlord's information

Landlord's Name

Address

City/StateZip Code

Phone Number/email
Landlord's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
IF YOU RENT/LEASE - Are there pet or breed restrictions in your rental/lease agreement?

YesNo
IF YES: please provide documentation of any pet or breed restrictions from your rental/lease contract

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
Cancelof
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

CityState

Zip Code
Veterinarian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How many dogs do you currently have?*
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.*
If this is your first dog, please note that above.
How many cats do you currently have?*
Are your current dogs/cats spayed/neutered?*

Yes. Everyone is spayed or neuteredNo. None are spayed or neuteredNo. Not everyone is spayed or neutered due to my veterinarian's recommendation.I have no dogs or cats currently.
Are/were your dog(s)/cat(s) current on core vaccinations (Rabies, DHLPP/DA2PP) and HW/flea/tick prevention? (Choose all that apply)*

YesNoDon't knowSome are not - due to veterinarian recommendationsCurrent on core vaccinations but not HW/flea/tick preventionNo 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.

pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
Cancelof
Have you ever surrendered or given away a dog?*

YesNo
IF YES, please explain in detail here:
Is your yard fenced?*

YesNo
IF YES, what type of fencing do you have? Check all that apply.

Physical Fence - fully fencedPhysical Fence - partially fencedInvisible/underground FenceHalo or other WIFI type virtual fenceOther
IF NO - please describe how you will keep your dog safe.
How do you plan on exercising your dog?*
How do you plan on socializing your dog?*
Why are you interested in adopting this dog?*
Tell us how you plan on training a new dog:*
How do you feel about shock/vibration collar training?*
Do any members of your family have animal related allergies? Choose all that apply*

YesNoDogCatApplicantFamily member within the houseFamily member who visitsControlled with medicationNot severe enough for medication
Who will be primarily responsible for caring for a dog? Check all that apply*

ApplicantSpouse/partnerAge appropriate children with parental guidance
What are the working hours of the adults in the household?*
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?*
How do you feel about crate training and crating your new dog when unsupervised? (choose all that apply)*

Agree with crate trainingDisagree with crate trainingHave no experience with crate trainingHave no opinion on crate trainingAm willing to utilize a crateAm not interested in utilizing a crate
Where will the dog be kept when left alone?*
What food do you plan on feeding?*
How will you housetrain your dog?*
Please describe your lifestyle.*
What characteristics are you looking for in a dog?*
What characteristics do you find undesirable in a dog?*
Would you adopt a senior dog?*

YesNoDepends on the dog
Would you accept a dog that has been abused?*

YesNoDepends 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?*

YesNo
Are you willing to hire a trainer as opposed to returning the dog if behaviors arise?*

YesNo
Describe in detail how you will manage unwanted behavior:*
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?*

YesNo
Have you (or any member of your household) ever been charged with domestic violence?*

YesNo
Have you (or any member of your household) ever been charged with child abuse/neglect/endangering?*

YesNo
Personal reference - family, coworker or friend*

First NameLast Name
Personal Reference's email*
example@example.com
By signing electronically below you are agreeing that the information provided is correct. *
Please type your name.
Should be Empty: