Adoption Application
Name of the dog are you interested in?
*
Your Name
*
First Name
Last Name
Date of Birth
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years at this address.
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Occupation
*
*
Full Time
Part Time
Work from home
Other
2nd Applicant (spouse/significant other)
*
First Name
Last Name
Date of Birth
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years at this address.
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Occupation
*
*
Full Time
Part Time
Work from home
Other
Is this a single family home or shared household? If shared/other please explain.
*
Single
Shared
Other
If shared, please explain.
*
Are you the head of household, if not, do you have head of households permission?
*
Yes
No
Other
How many people live in your household, (please include ages).
*
Is your home
*
Apartment
Condo
Ranch
Other
If Other, please explain.
*
Do you own your home?
*
Yes
No
If you Rent: Do you have permission from your landlord
*
Yes
No
Please provide Landlord contact details.
*
Is there a HOA agreement.
*
Yes
No
Are there any Breed / Weight restrictions?
*
Yes
No
Have you ever owned a dog before if so is the dog
*
Still with you
Rehomed
Deceased
Other
If your answer is rehomed or other then please give details.
*
Why do you want to adopt a dog?
*
Family companion
A gift
Protection for home
Protection for business
Other (please specify)
Many rescue dogs are mixed breeds and often their breed and age is estimated. Is there any breed that you would not want to adopt and why?
*
Ideally, what type of dog are you looking for, age, gender, breed, temperament. Please give us more details.
*
Do you want a dog that is already potty trained?
*
Yes
No
Preferably
It doesn’t matter
What type of dog do you prefer?
*
Indoor only
Outdoor only
Indoor/outdoor
Other
Where will your dog sleep at night?
*
Inside
Outside
Crate
Garage
Other
Do you plan on crate training?
*
Yes (Recommended)
No
Not sure
Do you have a pool and if so is it fenced?
*
Yes I have a pool
Yes, it is fenced
No, it is not fenced
No Pool
Do you have any other pets?
*
Cats
Dogs
Other
If the answer to the last question is yes, please tell us more about them. Do they have an alpha temperament or are they mellow, shy, energetic, couch potato etc?
*
If you currently have other dogs and if so, are they all spayed/neutered?
*
Yes (we may require proof)
No
Is there a fully fenced
*
Yard
Patio
Kennel/run area
Other
Typically, during what hours in the day will the dog be home alone? (eg. 9am to 5pm) Please INCLUDE travel time to and from work.
*
Where will the dog stay when you are not at home?
*
If you had to relocate, where would the dog go?
*
What would you do if your dog developed any behavior issues.
*
How would you handle expensive veterinary needs or emergencies?
*
Are you planning on docking this dogs tail or cropping this dogs ears?
*
Yes
No
Dogs live 10-15 years. What would happen if your circumstances changed (Moved, new baby, divorce)?
*
What dealbreakers would cause you to return/rehome a dog?
*
Is there anything else you would like to add to support your application?
*
Signature
Print
Submit
Submit
Should be Empty: