Pet Adoption Application Form

Please remember to hit "SUBMIT" at the end or your information will not be saved and sent to us. Contact us at admin@wonderdogz.com with any questions regarding this form. Thank you!

Full Name *

First Name Last Name

Date of Birth *

E-mail *

Address *

Street Address

Street Address Line 2

City State

Zip Code Country

Phone Number - Home *

Area Code Phone Number

Phone Number - Cellular *

Area Code Phone Number

Employer *

*

Street Address

Street Address Line 2

City State

Zip Code Country

Do you live in a: *

Do you: *

Own Rent Live with Parents Other

If renting, indicate landlord contact information:

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Household Setting

Rural Suburban Urban

Describe your Homes Activity Level *

Busy/Noisy Moderate Comings/Goings Quiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age) *

Have you applied to adopt with any other rescues? If so what were the results?

Are all members of your Family agreeable to Adopting a Dog? *

Yes No

Please List any Current Pets (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm *

Would you be willing to have a Wonder Dogs representative call your veterinarian for a reference check? (Please authorize vet to speak with us) *

Yes No

Veterinarian Name

First Name Last Name

Select if you currently have no Veterinarian

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number

Area Code Phone Number

Are you willing to adopt a dog of any age? *

Yes No

If no, what age would you consider?

What size dog are you willing to adopt? (Check all that apply) *

Small Medium Large No Preference

Are you willing to keep your new dog on heart worm prevention and keep him/her vaccinated? *

Yes No

If No, please explain

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience? *

Yes No

Do you have a fenced yard? *

Yes No Partial

How many hours in a day would the dog be left alone? *

Date *

Month Day Year

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully. I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Wonder Dogs Inc. animal adopted by me. I certify that the above information is correct, and I understand that the information will be verified. I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Wonder Dogs Inc. and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the adopted dog. I accept full responsibility for the dog(s) actions at all times, and release Wonder Dogs Inc. from any liabilities or damages that may be incurred because of adopting such dog(s). I agree to have Wonder Dogs Inc. complete reference call checks and conduct a home visit inspection to be able to approve my adoption application. I agree that if I'm unable to keep the dog(s) anymore that I will return the dog(s) to Wonder Dogs Inc. and try to give Wonder Dogs Inc. a 2 week period to try and find a suitable foster for the dog(s).

Which dog are you interested in adopting?

Name *

First Name Last Name