Adoption Form - GPA-AZ

GPA-AZ Adoption Application
Name*

First NameLast Name
E-mail address*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Daytime Phone Number*

Area CodePhone Number
Evening or Alternate Phone Number

Area CodePhone Number
Names of others sharing your home
Do you currently have pets?*

YESNO
If yes to pets, please describe*
Have you ever given up or lost a pet?*

YESNO
Please provide details of loss
How long have you had previous pets?*
What type of housing do you have*
If renting, proof that pets are OK*

YESNO
Type of exercise area*
How did you hear about GPA-AZ?*
What is your Greyhound knowledge level?*

1 - low2345 - high
Why do you want a Greyhound?*
Is an adult home during the day?*

YESNO
How long will the dog be left alone?*
Do you have a pet door?*

YESNO
If no door, are you able to let the dog out?*

YESNO
Do you have funds to support a dog?*

YESNO
Where will the dog spend daytime?*
Where will the dog spend night time?*
Do you have cats?*

YESNO
Do you plan to have cats?*

YESNO
Rate your dog knowledge*
Your veterinarian's name
Your vet's address/phone*
May we contact your vet as a reference?*

YESNO
May we contact you to check on the dog?*

YESNO
Do all household members agree to our terms?*

YESNO
Would you adopt a "special needs" dog?*

YESNO
Is there a dog you are currently interested in?
I agree to all the terms of adoption listed above*

YESNO
Should be Empty: