DOG ADOPTION APPLICATION
Is there a dog you've seen online that you are interested in? If yes, please provide dog's name.
Do you have a preferred age range or age limit for your adopted dog? If yes, please provide.
Is there any particular breed(s) you are interested in? If yes, please provide breed(s).
Is there any particular breeds you are NOT interested in? If yes, please provide breed(s).
Do you have a preferred sex for your adopted dog? If yes, please provide sex.
Why are you thinking about adopting a pet at this time?
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Would you be willing to accept a dog with some health problems? Comment/explain, if you'd like.
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Would you be willing to accept a dog with some behavioral problems? Comment/explain, if you'd like.
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Are size/look important to you? If yes, please describe.
Tell us a little bit about you
First and Last Name?
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Physical Address? Please include zip code.
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Email Address
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Phone Number
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Best time to call?
Tell us about your work
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Employed full-time
Employed part-time
Employed, but work from home
Unemployed
Retired
At-home parent
Other
Any additional comments about your work?
If applicable, please list your place of employment.
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Please provide a personal reference who is unrelated to you. Include email address (preferred) and phone number.
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What type of home do you have?
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House
Condo/Townhome
Apartment
Mobile home/RV
Other
Tell us about your home. Do you...
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Own
Rent from property managers
Rent from family/friends
Live with others
Other
If you rent or have a homeowner's association, are there any size or breed restrictions? Please describe.
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If you rent, do you have permission to have a pet?
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Please Select
Yes
No
N/A
If you rent, please provide your property manager's name and contact information. Include email address (preferred) and phone number.
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How long have you lived at your current address?
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Please Select
Less than 1 year
1-2 years
3-5 years
More than 5 years
If less than 1 year, please provide a previous address.
If yard is fenced, please describe height and type. Type N/A if not fenced.
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If yard is not fenced, how do you plan to handle exercise and toilet duties? If yard is fenced, do you plan to provide additional exercise?
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How old are you?
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How many adults (besides you) live in your home and what are their ages?
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Please provide full name of all other adults in household?
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What is your marital status?
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If you have children or children that frequently visit, please provide ages.
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Tell us about plans for your future dog
How many hours, on average, will the dog spend alone? Please describe.
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If you move, what will you do with this dog? Please explain.
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Where will the dog be when you are at home during the day?
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Loose indoors
Loose outdoors in fenced yard
Indoor crate/kennel
Kenneled outdoors
Tied/chained outdoors
Basement
Garage
Other
Where will the dog be when you are away from home during the day?
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Loose indoors
Loose outdoors in fenced yard
Indoor crate/kennel
Kenneled outdoors
Tied/chained outdoors
Basement
Garage
Other
Where will the dog be at night?
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Loose indoors
Loose outdoors in fenced yard
Indoor crate/kennel
Kenneled outdoors
Tied/chained outdoors
Basement
Garage
Other
How do you plan to discipline your dog? Please explain.
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Do you plan to take your dog to training/classes? Please explain.
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How do you plan to protect your dog from fleas? Please explain?
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Do you know how to prevent heartworm disease? Please explain.
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Would you be willing to return any adopted dog that you received through us if you are unable to keep it for any reason?
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Yes
No
Other
What circumstances, in your mind, justify giving a dog up? Please explain.
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Tell us about current or previous dogs
Will this be your first dog as an adult? Explain/comment, if you'd like.
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Do you own any other pets? If yes, please provide name, breed, sex, and age of each.
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Please list any veterinarian(s) used for current/former pets. Include city/state or zip code.
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Please list all pets you have owned in the past 5 years.
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If you no longer have pets above, please give details explaining what happened to them.
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Have you ever given a pet up for adoption or had one put to sleep at an early age? Please explain.
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By checking 'I Agree,' I certify that the above information is true to the best of my knowledge.
I Agree
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