Adoption Application Form
Please complete if you are interested in applying to adopt one of our released dogs.
Ontario Residents Only.
Date
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Month
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Day
Year
Date Picker Icon
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
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Home Phone Number
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Area Code
Phone Number
Cell Phone
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Area Code
Phone Number
Work Phone
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Area Code
Phone Number
Are you interested in adopting a dog to help support you or someone in your household as a companion? *Note: companion dogs do not have public access.
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Yes
No
If you answered yes to the above question, please describe how the dog will help your family member as a companion.
If you are requesting a dog to support a family member with a special need, please list a diagnosis or identify the reason you feel a companion dog would be helpful to this individual.
Have you or your family had any experience with crate training a puppy/dog?
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Yes
No
Have you or your family had any experience with obedience training a puppy/dog?
Yes
No
Have you or your family had any experience with raising and or resculng an older puppy/dog?
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Yes
No
Do you currently own a dog, or have you owned a dog in the past 5 years?
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Yes
No
If No, have you had a dog in the past? Please describe when.
Please list the dogs you own or have owned in the past. Include breed, activity level, gender (spayed or neutered):
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Do you currently have any dogs or pets in the home?
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Yes
No
Please list all pets currently living in the home, including breed & age:
If you do not have any dog(s) in the home please explain why or explain what happened to the dog(s)
Does anyone in your home have allergies to dogs/cats?
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Yes
No
Are there any special considerations you have in adopting a dog?
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How many people currently live in your household?
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How many adults and how many children? What are the age groups of the children?
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Are dogs permitted where you live?
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Yes
No
Do you own or rent your home?
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Own
Rent
Please describe your home (check appropriate boxes)
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Detached
Semi Detached
Townhouse
Apartment
Check type of yard you have
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No yard
Small yard
Large yard
Acerage
Is the yard:
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Fully fenced
Partially fenced
Open
Invisable fence
How many hours would the dog be left unattended during the day?
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Is there someone able to relieve and exercise the puppy through the day?
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Yes
No
Possibly
Where will the dog stay when you are not home?
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Crate
Will have run of house
Outside
In a dog run outside
In a room in the house
In the basement
In the garage
Other
Do you have any dog training experience?
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Yes
No
If yes, please describe your experience
Describe the type of dog you would like to adopt:
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Where will the dog stay when you are home?
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Describe the type of activity level you are looking for in a dog?
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List some of the things you would like to do with your dog:
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Do you have a preference in the breed or gender of the dog? If so please explain.
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Are you prepared to accept the responsibilities associated with adopting a dog that has special needs or health issues?
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Yes
No
Maybe, depending on condition
I understand that being a responsible dog owner maeans making the commitment to caring for the dog for the rest of its life, and that the dog can live to approximately 15 years of age.
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Yes
No
How did you hear about ADS?
References.
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