Life Animal Rescue Dog Adoption Application
Thank you so much for your time and interest. We try to get back to everyone in a timely manner and make the best match possible for your family and the dog you are interested in.
Date
/
Month
/
Day
Year
Date
I would like to Adopt (Dog's name and type):
*
Your Name
*
First Name
Last Name
Cell or Home Number
*
-
Area Code
Phone Number
Work Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
Postal / Zip Code
Have you ever adopted from us or filled out an application before?
*
Yes
No
Name of animal you adopted:
Who shares your home?
*
Spouse
Roomate
Children
Live Alone
With parents
Significant Other
What are the ages of your children, if any?
Is this your child's first Pet?
Yes
No
Do you live in a
*
House
Apartment
Condo
Townhouse
Mobile Home
Military Housing
Do you own or rent?
*
Own
Rent
If you rent, do you have permission to have a dog?
Yes
No
Is anyone in your household allergic to dogs?
*
Yes
No
Slight allergies
What type of dog are you looking for?
*
Primarily an inside house dog
Out all day, in at night
In and out as they want
Primarily an outside dog
Do you have a doggy door?
*
Yes
No
If no, would you consider installing a doggy door?
Yes
No
If yes, does your doggy door have access from:
House to yard
Garage to yard
House to garage to yard
Is your dog allowed on the couch?
*
Yes
No
Is your dog allowed on the bed?
*
Yes
No
Where would your dog sleep at night as a Puppy?
*
Anywhere in the house
Anywhere outside
Crate
Kitchen
Laundry Room
Bedroom
Garage
Patio
Dog House
Dog Run
Where would your dog sleep at night as an Adult?
*
Anywhere in the house
Anywhere outside
Crate
Kitchen
Laundry Room
Bedroom
Garage
Patio
Dog House
Dog Run
If you have a dog now or had a dog previously, where do they (or did they) sleep at night? Please be specific about the room or area inside or outside of your house
*
Do you plan on using crate training at any time?
*
Yes
No
If so, when?
Is anyone home during the weekday?
*
Almost all the time
Part of the time
Only evenings and weekends
Who is home?
*
How many hours will the dog be left alone on a normal weekday?
*
When you are home, will the dog have?
*
Full run of the house
Only part of the house
Mostly outside
When you are not home, will the dog be put?
*
Full run of the house with outside access
Inside with full run of the house
Inside with partial run of the house
Part of the house with outside access
Outside only
Crate
Is your yard securely fenced?
*
Yes
No
Height of fence?
*
Type of fencing?
*
Do you have grass in your yard?
*
Yes
No
Do you have a pool?
*
Yes
No
Is it fenced off?
Yes
No
Do you have a dog run area on the side of your house?
*
Yes
No
If yes, is your dog
Limited to the run area
Dog run is always open
Dog is sometimes locked in run
What type of exercise do you plan on doing with your dog and how often?
*
Have you ever had a dog before any current dogs you have now?
*
Yes
No
If yes, what happened to your previous dog(s)?
Do you have any other dogs now?
*
Yes
No
If yes, how many, their age(s) and what type?
Do you have any other type of animals?
*
Yes
No
What kind?
Are all your pets spayed/neutered?
*
Yes
No
If no, why not?
Where will your pet stay when you go on vacation?
*
What type of dog food do you feed or have fed in the past?
*
If something was to ever happen to you, what provisions do you have in place for your dog?
*
Under what circumstances would you give up your dog?
*
I would never give up my dog
Divorce
Moving
New Baby
House-training issues
Digs or destructive
Out of control or Un-trainable
Large Vet bills
Barks too much
Nips/bites
Comments or Questions
Submit
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