Adoption Application

Thank you for considering one of our homeless animals as your new best friend!

We know those cute faces can lead to impulse decisions; so, please remember that when adopting one of these homeless animals, you are making a commitment to the life of that pet. Dogs can live 10 to 15 years. For this reason, we want to remind you to think through your expectations and needs for your new pet as you answer the following questions. We also urge you to send any questions you may have back to us. Once your application is approved, we will assist you in adopting a companion that will be the right match for your family.

The adult dog adoption fee is $175.00. The puppy adoption fee is $200. Adoptable dogs are up to date on all vaccinations, spayed or neutered, microchipped, heartworm tested, and kept current on monthly heartworm and flea/tick prevention.

Note: This application does not obligate you in any way. It just lets us know about you and your expectations in a new pet, so that we may better assist you in finding the right dog. We want to ensure the best possible fit for both you and your new pet.

Application Status

Reason/Outcome

Name*

First NameLast Name

Date of Birth*

MonthDayYear

Co-Applicant (Spouse/Partner/Roommate)

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

What area do you live in?

Home Phone

Work Phone

Mobile Phone*

E-mail*

Occupation*

Co-Applicant Occupation

Name of Dog You Are Interested In Adopting*

Note: If you are not interested in a specific dog, please describe the type of dog you are looking to adopt.

Why Are You Interested in Adopting this Dog?

Are You a Student?

Do you own or rent your home?*

If Other, please explain.

Do You Have the Landlord's Permission to Adopt an Animal?

Landlord's Name

First NameLast Name

Landlord's Phone Number

Is a Pet Deposit or Fee Required?

Yes, I have already paid it!Yes, but I have NOT paid it yet.No Deposit or Fee required

Which type of housing best describes your home?*

Do You Have a Pool?*

Do You Have a Pet Door?*

Do you have a completely fenced in yard?*

If no, how do you plan to confine the dog to your yard?

What type of fence do you have?

WoodChain LinkWrought IronOther

How Tall is Your Fence?

Does Your Job Require You to Travel Often?

When Traveling, What Do You Do With Your Pet?

How Many Adults Live in Your Home?

Do Any Children Live in (or Visit) Your Home?

If yes, please list the age of each child:

Please list the pets you currently own. [Name, Breed, Male/Female, Age]

Example: 1. Duke, Pit Bull, Male, 8 year old

Please list the pets you have had in the past and explain what happened to them.

Example: 1. Otis, English Bulldog, congestive heart failure, 13 1/2 years old

Are your pets vaccinated? *

Are your pets on heartworm prevention? *

If yes, what brand?

If no, please explain.

Are your pets spayed/neutered?*

If no, please explain.

Example: Too young to spay/neuter, medical condition preventing spay/neuter, etc.

Who is your Veterinarian?

First NameLast Name

Vet Clinic

Vet's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Vet's Phone Number

How Many Times a Day Do You Feed Your Pets?

What Brand of Food Do You Feed Your Pets?

Please describe what a typical day and a typical week will be like for your new pet.

Where will the dog spend its days?

Where will the dog sleep at night?

How many hours a day will the dog be left alone?

Where will the dog stay when no one is at home?

How long do you plan to keep this dog?

What behaviors would you consider unacceptable in your pet?

How would you correct these behaviors?

What would you do if your dog kept having accidents in the house?

How would you discipline your dog from unwanted behavior?

Have you ever kennel/crate trained a dog before?

Are you prepared for the costs involved in properly caring for a pet?

food, treats, toys, grooming, shots, heartworm and flea/tick prevention, etc.

Many breeds are now banned in apartment complexes and by insurance companies. If you are applying for a Rottweiler, German Shepherd, Akita, Doberman, Pit Bull, Chow Chow or other guardian type breed, have you checked with your renters/homeowners insurance to make sure that you are allowed to own the breed?*

If you are applying to adopt a Rottweiler from us, which insurance company are you with?

Name of the insurance company that provides your renters/homeowners insurance policy.

Is the animal going to be a gift for someone?

Are the other members of your household aware that you want to adopt an animal?

Is anyone in your family allergic to animals?

Do you have any health issues that might affect your ability to care for a pet?

If yes, please explain.

Have you adopted an animal before?

If yes, from where?

How did you hear about us?

Do you understand that if you adopt a pet from us, you are required to return the pet to us if you can no longer keep it?*

Please list 2 Personal References (Name & Phone Number)

(1) Name*

First NameLast Name

(1) Phone*

(2) Name*

First NameLast Name

(2) Phone*

If you live outside of the Greater Memphis Area (West TN / North MS / Eastern AR), how do you plan to get the dog?

If you live in or near Memphis, TN, you may skip this question.

If you live outside of the Greater Memphis Area, how would you return the dog to us if the dog didn't work out in your home?

If you live in or near Memphis, TN, you may skip this question.

Please include any additional comments you would like to make that will help us make a good decision for you and for your new companion. If you have any further questions for us, please also include these questions in the "Additional Comments" box.

Additional Comments

Thank you for your interest in one of our homeless pets!

Your answers will be reviewed and your vet reference will be contacted. We will contact you as quickly as we can, but please remember we deal with a high volume of calls, emails, and applications.

Please note, an incomplete application WILL NOT be processed. Falsification of any of the above information will be grounds for rejection of this application.

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Contact Notes

Adoption Questionnaire