Dog Adoption Application
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Apt or Unit #
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Occupation/Employer
*
Which animal are you interested in adopting?
*
If the animal you are interested in is unavailable, would you be interested in hearing about another?
*
Yes
No
How many people reside in your household? What are the ages for all individuals in your household?
*
Are there any people in your household with special needs?
*
Do you own or rent your home?
*
Own
Rent
Did you receive approval from your landlord to have a pet?
*
Please provide your landlord's name and phone number:
*
Do you belong to a Homeowners Association (HOA)?
*
Yes
No
Please provide your HOA name and contact information. How many pets are you allowed to have?
*
Length of time you have been at this address:
*
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Is your yard fenced?
*
Yes
No
What type of fencing, what is the height?
*
How much time will the pet be spending alone during the day?
Where will the animal be kept when left alone?
*
Where will the pet sleep?
*
Describe how you will train the pet
*
Have you ever had to surrender a pet?
*
Yes
No
If "yes," please explain
*
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Please provide your veterinarian’s name and telephone number
*
Do you have other pets?
*
Yes
No
If so, please describe (type, age, sex, breed, spayed/neutered)
*
Are your cats and dogs current on their vaccinations, rabies and heartworm protection?
*
Yes
No
What happened to your previous pets?
*
How often will the pet be exercised?
*
Have you ever been convicted of a felony?
*
Yes
No
If yes, please explain
*
Please provide 2 references that are not related to you
*
Please share links to your social media profiles or personal websites that you feel represents who you are. (OPTIONAL)
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Signature
*
Date:
*
Submit
Submit
Should be Empty: