Dog Adoption Application

Dog Adoption Application
The dog that you are interested in:
Your Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Are you at least 18 years of age?

YesNo
How long have you lived at your current residence?
Do you rent or own your home?

RentOwn
Type of home?

HouseApartmentStudioDuplexCondoMobileParentsOther
Landlord's Name

First NameLast Name
Landlord's Phone Number

Area CodePhone Number
Does you landlord allow pets?

YesNoNot Sure
Does your landlord charge a pet deposit?

YesNoNot Sure
Are you planning to move in the next 6 months?

YesNoNot Sure
If you had to move unexpectedly, what would you do with your animals?
Current Employer
Hours you work per day?
Would your employer allow you to bring a dog to work with you?

YesNoNot Sure
Are you a student?

YesNoPart TimeFull Time
Hours at school per day?
Hours at school per week?
List all other people living in your household: Name, Relationship to you, Age, Any dog allergies
How many animals have you owned as an adult?
What kind?
What happened to your last 2 animals? Please be specific, i.e. species, breed, age, what happened to them?(died is not a specific answer)
Have you ever rehomed an animal?

YesNo
Have you ever surrendered an animal to the shelter?

YesNo
If yes, what were the circumstances?
What circumstances would cause you to rehome a dog?

MovingDivorceNew babyIncreased work hoursNo timeChildren not helping with careAllergiesMedical problems with familyMedical problems with dogToo bigSheddingAggressiveBarkingChewing or destructiveGetting out of yardNot housebroken/markingNot getting along with childrenNot getting along with other animalsNoneOther
Please list all animals living in your household: Name, Species, Breed, Gender, Age, Spayed/Neutered
Why are you looking for a new dog now?
How long have you been looking for a dog?
What energy level would you like your new dog to be?

LowMediumHighOther
Where will your new dog spend the day?
Where will your new dog spend the night?
Do you have a yard?

YesNo
If yes, about what size?
Is your yard securely fenced?

YesNo
Types and heights of fencing?
What percent of time will your dog spend inside the house?
Approx. how long will your dog be alone during the day?
What methods will you use to train your new dog?
Do you plan on enrolling your dog in training classes?

YesNoNot sure
Will you be crate training your dog?

YesNoNot Sure
How will you discipline your dog if it misbehaves? (gets into the trash, chews your shoes, etc)
What activities do you plan to do with your dog?
What brand of food do you plan to feed your dog?
Where will the dog stay when you go out of town?
A dog's lifespan is 10-20 years. Can you commit to a dog for its entire life?

YesNo
Would a vet bill of $200 or more be a burden for you?

YesNo
If you could no longer keep or provide for your animals for any reason, what would you do with them?
If you were to pass away, what would happen to your animals?
Is there anything else you would like us to know?
Current Veterinary Hospital
Vet's Phone Number

Area CodePhone Number
I hereby state that the above information provided herein is complete and correct. Any information found to be false without reasonable explanation may terminate this adoption. By signing my name below, I give Mending Mutts permission to contact my veterinarian and landlord.
Signature

Clear
Date

MonthDayYear
Date
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