Dog Adoption App

Dog Adoption Application
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long at this address?:
Are you planning on moving within the next 6 months?
If yes, what are your plans for your pets if you move?
Cell Phone Number

Area CodePhone Number
E-mail
Are you 18 years of age or older?
Birth Date

MonthDayYear
Do you own your own home?
If no, name and phone # of landlord:
Type of Dwelling:
Name and age of ALL occupants in household (including yourself):
Most of the dogs for adoption will need regular grooming. Will you be able to get the dog groomed every 6 to 8 weeks?
What is your reason for wanting to adopt a dog?
If other, please explain:
How many total hours will your new pet be left alone during the day?
How many total hours will your new dog be outside alone during the day?
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?
Will your adopted dog or do your current dogs be put on a tie out?
Are any members of your household allergic to animals?
If yes, please describe:
Who will have chief responsibility for the care of your new pet?
Over the past 5 years, how many pets have you owned? (Include current pets)
List each individually including breed, age, still living with you? (if not, why?)
Have you and your spouse (if applicable) ever owned a pet together?
Have you ever lost (pet "ran away") 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 present pets spayed or neutered?
If no, please explain.
Were your previous 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?
Which dog(s) are you interested in?
Age of dog you would consider adopting: (check all that apply)
Can/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:
Is your entire immediate family in agreement with the decision to bring a new pet into your home?
If anyone is NOT, please explain:
Are you prepared to commit to a pet for 10 - 15 years (average life span)?
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?
If yes, please describe:
Where will your dog spend most of his/her time?
If you selected outdoor, would your dog be supervised?
Where will your dog eat?
Where will your dog sleep?
If there is anything else you think we should know, please note it here.
Please agree to and confirm the following:

I understand that adopting a young or adult dog means that the dog may take time to adjust to myself, my family, and my home. I understand that this can take three days to three months of time. I understand that I will need patience and understanding. I will not give up on the dog just because it takes time for him/her to adjust. Knowing all of this, I plan to give this/the dog(s) the time and understanding that they need to feel comfortable with me and in my home. I do not plan on bringing the dog back because I do not get immediate gratification as a new adopted owner.
Thank you so much for wanting to adopt a dog!! Once you submit the application, you will be taken to a page that will allow you to sign up for an appointment to meet the dog(s) on October 18, 2025. Sign up will be available until October 17, 2025.
Should be Empty:

Dog Adoption Application

Thank you so much for wanting to adopt a dog!! Once you submit the application, you will be taken to a page that will allow you to sign up for an appointment to meet the dog(s) on October 18, 2025. Sign up will be available until October 17, 2025.