Adoption Application

Adoption/Foster Application

Please fill in the form below.
Are you wanting to Foster or Adopt?
Full Name

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long at current address?
Phone

Area CodePhone Number
E-mail
Type of home

Other
if "other" please explain
Please list all adults, including age, who live in your home
Please list all children, including ages, who live in your home
Do you own or rent?
If you rent, are you able to provide proof that you are allowed to have pets?
Is your yard fenced?
Have you fostered for any rescue or shelter? If yes, which rescue?
How many hours a day will the dog be left alone?
Where will the dog be kept when alone?
Please list ALL pets
Are all pets spayed or neutered and up to date on all medical care? If not, explain
Do you use heartworm prevention?
Have you ever given up a pet? If so, explain
How do you discipline a dog?
Are you willing to attend training with your new dog?
What food do you feed your dog?
Veterinarian name, address and phone number. If more than one vet was used, list them all
Personal Reference #1
name, address, phone and email
Personal Reference #2
name, address, phone and email
Would you be interested in a dog with Special Needs?
What energy level are you looking for in an adopted dog?
Is there any reason you would give up a dog?
Are you looking for an inside or outside dog?
Are you prepared to deal with a serious illness or injury?
Tell me about what you are looking for in a pet
Electronic Signature
I certify that all information in this form is true and honest
Should be Empty:

Adoption/Foster Application