Dog Adoption Application
Roo's Rescue
Thank you for your interest in adopting! Our goal is to place dogs in loving, safe, and permanent homes.
Applicant Information
Full Name:
Address:
City / State / Zip:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Preferred contact method:
Phone
Text
Email
Age (must be 21+):
Household Information
Type of residence:
House
Apartment
Townhome
Other
Do you:
Own
Rent
If renting:
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Next
Landlord Name:
Landlord Phone:
Format: (000) 000-0000.
Does your lease allow pets?
Yes
No
Household Members
List everyone living in the home.
Name Age Relationship
Current Pets
Do you currently own pets?
Yes
No
If yes, list below:
Pet Name Type Breed Age Spayed/Neutered
Veterinarian Name:
Vet Phone:
Format: (000) 000-0000.
Lifestyle Questions
Where will the dog stay during the day?
Where will the dog sleep at night?
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Next
How many hours per day will the dog be alone?
0-2
3-5
6-8
8+
Do you have a fenced yard?
Yes
No
If yes, fence height:
Dog Preferences
What type of dog are you looking for?
Puppy
Adult
Senior
Small
Medium
Large
Energy level preference:
Low
Medium
High
Agreement
I certify that the information provided is accurate and that I agree to provide proper care, shelter,
and veterinary care for the adopted dog.
Signature:
Date:
-
Month
-
Day
Year
Date
Preview PDF
Submit
Should be Empty: