Dog Adoption Application

Dog Adoption Application
Please fill out this form as completely and honestly as possible. Our goal is to make sure we are making the best match for you. Our adoption fee is $250, which covers the spay or neuter, vaccines, and microchip.

The Animal Adoption Center cannot guarantee the breed, compositiuon or ages of our dogs, as we usually have little to no history prior to them entering the rescue. We make every effort to ensure the dogs are healthy.

All fields are required to be submitted. If a question does not apply to you please say "n/a".
Which dog(s) are you interested in adopting? Or what type of dog are you looking for?*
First Name:*

First NameLast Name
Name of Spouse or Significant Other

First NameLast Name
Age*
Age of Spouse or Significant Other
Cosigner Name (Required if adopter is under 24 - Cosigner must be over the age of 24)

First NameLast Name
Cosigner Phone

Area CodePhone Number
Cosigner Email
example@example.com
Physical Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address*

Mailing Address

Mailing Address Line 2

CityState

Zip Code
Mobile Phone*

Area CodePhone Number
Secondary Phone

Area CodePhone Number
E-mail*
Co-adopter email
example@example.com
Your Occupation*
Place(s) of Work*
Hours at work/week*
Where did you hear about the Animal Adoption Center?*

RadioNewpaperFriends/FamilyCommunity/Adoption EventOther
If you rent, the Animal Adoption Center staff must receive a verbal confirmation from your landlord in order for your application to be approved.
Do you rent or own this property?*

RentOwn
It is very difficult to find housing in Jackson. What will you do if you cannot find dog friendly housing?*
If you rent, please provide your landlord's contact information. If you own, please put in your own name and phone number.*

First NameLast Name
Landlord's Phone Number*

Area CodePhone Number
I/We live in a*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
How many times have you moved in the last 5 years and what are your future housing plans?*
Would you consider moving into a home that did not allow pets?*
How many people are living in your home? Please include ages of children if applicable.*
(ex. family members, roommates, children, ages)
Where do you see yourself in 6 months? Any major changes to your life?*
(i.e. moving, changing jobs, going back to school etc.)
Where do you see yourself in 5 years? Any major life changes?*
(i.e. marriage, kids, retirement,etc.)
Please describe your home atmosphere.*
(ex. bustling with activity, fairly quiet, etc.)
Does anyone in your home have pet allergies?*
Does anyone smoke tobacco inside the home?*

YesNo
Please explain why you are interested in adopting at this time.*
Describe your dream dog to us! We want to make sure we are matching you with the perfect dog. *
Please tell us about your current pets!*
Are your current pets spayed or neutered?*
Current on Vaccinations?*

YesNo
Current veterinarian's name and phone number*
(Please mark n/a if not currently applicable)
Name(s) of pet seen at this vet?*
Are your pets kept indoor or outdoors?*
How do your current pets behave when new animals enter the home?*
What happened to your past pets?:*
Has a dog died or been ill on your premises in the last 6 months?*
If yes, explain:
Have you ever given up a pet? If so, please explain why, to whom and where:*
Please check all that apply. I want to adopt this dog...*

As a family petTo breed with my dogTo train/use for huntingTo train/use for agilityTo train/use as a therapy dogTo train/use as an assistance dog for the disabledTo use as a guard dogFor a partner for outside activities (ex. running, hiking, skiing)To interact with lots of friends/familyAs a gift for a friendAs a companion for my dog(s)As a companion for my cat(s)As a companion for my child/children
What qualities are you looking for in a dog?:*
Will this be your first dog? How long have you been looking for a dog? What breeds have you had past experience with?:*
What does a typical week in the life of your dog look like? *
How do you intend to better understand and support your dog should you face behavior challenges?*
What methods do you plan to use if training is warranted?*
What if your dog doesn't meet your expectations for behavior?*
Are you willing to adjust your expectations if your dog's behavior changes with time/age/circumstance?*
What will you do if you encounter an unexpected behavior problem? *
Are you aware that many dogs in transition behave differently once they are more comfortable,and that it can take weeks or longer for a dog in a new home to really show their true colors?*

Yes I am aware.No I didn't know that, I want to learn more.
Are you aware that we provide free behavior/training support if needed?*
Would you be willing to attend a free informational session about bringing home a new puppy or dog prior to or after adoption?*
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
When adopting a dog it is important to remember that your energy level should be close to the energy level of your dogs. Try to be realistic about your own energy levels; for example, don't commit to a type of dog that will require regular, heavy exercise if you are not ready to live a lifestyle that will support that.
What activity level do you prefer?*

High energy: Go Dog Go! This dog prefers an active lifestyle that provides them with ample opportunities to burn off energy and challenge them mentally.Medium energy: This dog understands when its time to go get some exercise and is eager to accompany you, but will relax and settle when it is down time.Low energy: This dog is a couch potato! They love to relax and go on leisurely strolls with their friendsOther
What in your mind would justify giving up a dog? (Please check all that apply).*

ChewingJumping on peoplePulling on leash during walksCounter surfingFear of men, women or childrenMouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training)Problem barkingRough play with other dogsHigh activity levelFood/toy aggression/not willing to share with other dogs or with peopleWhining/cryingSeparation AnxietySpecial DietLong Term MedicationAllergiesHousebreaking problemsMedical careMovingToo time consumingNew BabyDivorceNot getting along with other petsGetting out of fenced yardBehavioral ProblemsIt got too bigSheddingChildren lost interestThere is nothing that justifies giving up an animalAggressionOther
Please explain the reasons you selected.*
Puppy Specific Questions

Even if you are planning to adopt an adult dog, please fill this portion out. Many of the questions can pertain to an adult dog too!
We want our adopters to know that puppies are not blank slates and there is some degree of unknown (DNA, early life experience etc) - it’s not “all in how you raise them”*

I understand that.I didn't know that, help me understand!
Raising puppies and kids together means a lot more more work on the part of the parents. Kids and puppies can be a tough mix - lots of energy and lack of self control on both ends! If you have young kids in the home, are you prepared to manage that environment until they're old enough (kids and/or puppy) to behave appropriately?*

YesNo
If you have children in the home, the responsibility of raising the puppy is on the parents.*

Yes I agree.I will rely heavily on my children for help raising this puppy.
The risks of infectious disease to puppies does not outweigh the risks of under socialization.

“The American Veterinary Society of Animal Behavior believes that it should be the standard of care for puppies to receive.. socialization before they are fully vaccinated. Because the first three months are the period when sociability outweighs fear, this is the primary window of
opportunity for puppies to adapt to new people,
animals, and experiences. Incomplete or improper socialization during this important time
can increase the risk of behavioral problems
later in life including fear, avoidance, and/or
aggression”
I understand that socialization is a daily priority when raising a puppy.*

YesWhy is it so important? I need more information.
Did you know that the AAC's behavior team hosts Puppy Preschool every week? This is an hour of hands on learning and socialization for puppies 8 - 16 weeks who have been adopted from the AAC. We HIGHLY encourage adopters to attend Puppy Preschool each week to help set their puppy up for future success!*

I plan to attend every week!I don't plan to attend!
Raising a puppy requires focused and intetional hours each day in order to:

- Create a daily routine/structure for your puppy.

- Teach your puppy that elimination is for outdoors.

- Teach your puppy to be comfortable in confinement (crate, play pen etc).

- Teach your puppy what is appropriate to put teeth on.

- Build your puppy’s confidence out in the world.

- Manage your puppy around resident older dogs, cats, and kids until they are old enough to.

- Behave appropriately.
Do you have the time, energy, and willingness to accomplish everything on the list above?*

YesNo
Do you intend to provide this pet with a home for the next 10-20 years?:*

YesNo
What is your emergency back-up plan for this pet if something unavoidable were to happen to you?*
What would you do if your dog suddenly required emergency veterinary care for an illness or injury? Keep in mind that emergency vet care can cost between $250 and $1000. *
Do you have any additional comments, questions or concerns? Anything else you would like us to know to help match you up with a dog?*
Please supply 2 personal references with phone numbers and their relationship to you. A spouse/significant other cannot be used as a reference. Only one of your references can be someone related to you. If you'd like to use your veterinarian as a reference please also provide 2 other references in addition. If you are under 24 please provide 3 references. *
By initialing below you are agreeing to the following terms:
You agree to see a vet yearly for vaccinations or any time of illness or injury. You are aware that a dog can cost anywhere from $200 to upwards of $2500 annually. *
You agree to keep a collar, rabies tag, license, and identification tag with your information on your dog at all times.*
You agree to give your pet food and water, exercise, shelter, grooming, and all needed health care.*
You understand that AAC dogs will be spayed and/or neutered, not just sterilized.*
Please read the above, check this box, sign, and click Submit.

I/We have read and understand all of the above.
ACKNOWLEDGEMENT AND ASSUMPTION OF RISKS AND RELEASE AND INDEMNIFICATION AGREEMENT

PLEASE READ AND SIGN BELOW

I fully understand and agree to assume all risks involved in any activities that I take part in at the Animal Adoption Center and I agree to hold the Animal Adoption Center harmless for any injury(s), which I might sustain during the course of my interactions with the Animal Adoption Center.

The activities are as follows but are not limited to; interacting with dogs in the center, walking dogs, interacting with the cats in kitty city and fostering animals.

This waiver includes myself, all of my family members and descendants forever from seeking any legal action whatsoever against the Animal Adoption Center or its representatives.

I accept the animal as is and assume all risks of its ownership, including the risk of injury or damage caused by the animal (such as animal bites). On behalf of myself, my heirs, personal representatives and assigns, I hereby release, discharge, indemnify and hold harmless the Animal Adoption Center of Jackson, Wyoming and its directors, officers, employees, and agents from any and all claims, causes of action and demands of any nature, whether known or unknown, arising out of or in connection with my adoption.

By signing below I am attesting to the truthfulness of my answers. Falsification of any of the above information or a violation of the terms of this agreement will be grounds for disallowing or for the rescission of the adoption of an Animal Adoption Center animal and possible removal of an adopted animal from my home and fines up to $150.00. Applicant must be 24 years of age or older. The Animal Adoption Center reserves the right to refuse any applicant.
Applicant's E-Signature*
Co-Applicant's E-Signature
Applicant's E-Signature*
Co-Applicant's E-Signature
After you submit this form, it will take you back to the Animal Adoption Center home page. Feel free to email us with any questions: adopt@animaladoptioncenter.org or call 307-739-1881.

After reviewing your application, a staff member will contact you to discuss the next step in adoption.

Thank you for choosing adoption!
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Dog Adoption Application

Puppy Specific Questions

By initialing below you are agreeing to the following terms: