Adoption Application

Animal Adoption Application
Adoptable dogs can come from less than ideal situations. Most may need additional training, and all deserve kindness and patience. Our goal is to place every animal in a permanent, and responsible home. Most of our adoptable pets are strays and we have very little history. We can not guarantee age or breed. Both age and breed estimates are based upon advice from our veterinarian, our experience and the animals physical appearances, etc, again, it is just a guess.
Name*

First NameLast Name
NAME OF ANIMAL TO BE ADOPTED?
BREED OF ANIMAL TO BE ADOPTED:
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
what is you current living arrangement? house, condo, apartment
CURRENT PLACE OF EMPLOYMENT /YEARS EMPLOYED HERE. *
Email*
example@example.com
Phone Number*

Area CodePhone Number
Do you own or rent?
IF YOU MOVE, WILL YOU TAKE THIS ANIMAL WITH YOU?
How long have you lived in your current residence?
IF RENT, NAME AND PHONE NUMBER OF LAND LORD?*
LIST ALL PEOPLE LIVING AT THIS ADDRESS AND AGES OF CHILDREN ONLY*
NAME OF CURRENT OR LAST USED VETERINARIAN. INCLUDE PHONE NUMBER!*
We encourage you to contact your veterinarian to authorize them to speak with us when we call. Thank you!
LIST ALL ANIMALS YOU HAVE HAD IN YOUR HOME IN THE LAST 10 YEARS. INCLUDE: BREED, ANIMALS NAME, AGE OF ANIMAL, MALE OF FEMALE, SPAYED OR NEUTERED, CURRENTLY IN HOME? (Include animals that may not belong to you but you helped care for at least 50% of the time ie: parents pets- this shows how much experience you may have with animals)
OF THE ABOVE PETS WHAT HAPPENED TO THEM/OR CAUSE OF DEATH? LIST PET NAME AND REASON BELOW
Are dogs current on heartworm preventative? If so, what brand?*
In your opinion, what symptoms/behavior would warrant emergency treatment?
IS EVERYONE IN THE FAMILY IN AGREEMENT WITH THE PET YOU WISH TO ADOPT?
DO YOU HAVE A FULLY FENCED YARD WITH NO GAPS?
IF YES.. HOW HIGH IS YOUR FENCE?
TYPE OF FENCE: WOOD, CHAIN LINK, ELECTRIC OTHER (PLEASE SPECIFY)
If no fence, how will you ensure your pet is receiving adequate exercise?
APPROXIMATELY HOW MANY HOURS PER DAY WILL YOUR PET BE ALONE EACH DAY?
HAVE YOU DONE YOUR RESEARCH ON THE BREED TO SEE IF THEIR NEEDS ARE COMPATIBLE WITH YOUR LIFESTYLE?
What traits are you looking for in a dog?
WHERE WILL YOUR PET STAY DURING THE DAY?
(INSIDE HOME, KENNEL INSIDE HOME, KENNEL OUTSIDE, INSIDE GARAGE/PORCH, BOTH)
Do you plan on crate training your pet (if not already done)?
IF YOUR PET REQUIRES DISCIPLINE FOR BAD BEHAVIOR, HOW WILL YOU HANDLE THE SITUATION?
(ex: POTTY TRAINING ACCIDENTS, CHEWING, JUMPING, DIGGING, RUNNING AWAY, ETC.)
If necessary are you willing to housebreak your new dog in a positive and loving way? How would you go about doing so?
Under what circumstances would you find it necessary to rehome your dog?
HAVE YOU EVER HAD TO GIVE UP OR RELEASE A PET TO A SHELTER? IF YES, PLEASE EXPLAINE THE SITUATION IN DETAIL... *
PLEASE PROVIDE THE NAME AND PHONE NUMBER OF THREE REFERENCES, THAT ARE NOT RELATIVES. *
WOULD YOU AGREE TO A HOME INSPECTION BY A REPRESENTATIVE, IF REQUIRED?*
Is there any other information that you would like us to consider in matching the right dog to you and/or your family?
Most of the time we have limited knowledge of the animals we place. Therefore we cannot guarantee the health, behavior, temperment, age or breed of any animal adopted. In the event that you are no longer able to care for this animal in its lifetime, you will give us FIRST RIGHT OF REFUSAL, and return the animal to us so that we can ensure the animal is placed in a responsible home.

Once we receive your application, we will review it and contact your references. We will then email you regarding the next steps, usually a phone interview.

By submitting this form, you attest to the truthfulness of your answers. Falsification or misrepresentation of the above information will result in rejection of this application or possible removal of the pet from my home.

When finished with your application, please be sure to press the SUBMIT button to send.
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Animal Adoption Application