ADOPTION Application Form

How did you hear about Earthdog Rescue?

Full Name*

First NameLast Name

Phone number

E-mail*

Age

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you live in a:

Do you:

OwnRentOther

If you rent, we will require a letter from the landlord stating you are permitted to have a dog. Are you able to acquire this paperwork should it be needed?

YesNo

Please List all People and pets living in the Household (Include Name, Relationship, Gender and Age)*

Name of animal you are interested in adopting*

Why do you want to add a pet to your home?*

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?

YesNo

Do you have a fenced yard?

YesNoPartial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

Vet Reference: Full Name*

First NameLast Name

Phone Number

Area CodePhone Number

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):

Phone number:

Date

MonthDayYear

By submitting this application to adopt, I confirm that I am aware that adopting a dog includes road bumps, transitions, sometimes challenging but also a lot of wonderful times and I am committed to sticking it out through them all.*

type your name here

ADOPTION APPLICATION