Adoption Application

• Be sure to fill out all sections. Failure to do so will result in a delay of your application.

  Applicant Information
  First Name:
  Last Name:
  Address:
  City:
  State:
  Zip:
  Home Phone:
  Work Phone:
  Cell Phone:
  Email Address:
  Mailing Address If Different:
  Co - Applicant (If Applicable)
  First Name:
  Last Name:
  Complete answers to the following will help us match your specific needs and expectations.
  Age Desired:
  Specific Dog Your Interested In:	----- Yes No
  If Yes Name Color Gender
  Why Are You Interested In This One:
  Would you consider a Special/needs dog:	----- Yes No
  Will you accept a mix:	----- Yes No
  Activity Level:	----- High Medium Calm
  Sex:	----- Male Female
  Age of Family Members In The House:
  Do They Live With Or Visit You Often:	----- Yes No
  Do They Share Your Interest In Adopting A Dog:	----- Yes No
  Who Is The Dog Primarily For:	----- Adult Child Elderly
  Who will care for, train and exercise the dog
  Does anyone in your household have allergies	----- Yes No
  If Yes, to what allergens
  May we visit your home prior to application approval	----- Yes No
  If Yes, when is best (time and day):	----- 9:00am-12:00pm 12:00pm-3:00pm 3:00pm-6:00pm    ----- Monday Tuesday Wednesday Thursday Friday Saturday Sunday
  List most recent pets you have owned in the past
  Species:	----- Dog Cat Other
  Sex	----- Male Female
  Spayed/ Neutered	----- Yes No
  What happened to the pet
  Please add pet's name (vet check reasons)
  Veterinarian Information:
  Name:
  Address:
  City:
  State:
  Zip:
  Office Phone:
  Where do you purchase heartworm preventive
  Other Veterinarians That You Have Used Most Recently
  Name:
  Address:
  City:
  State:
  Zip:
  Office Phone:
  Housing Information
  How Long At Current Address:
  Own or Rented:	----- Own Rent
  Landlord Information
  Name:
  Address:
  City:
  State:
  Zip:
  Phone:
  Permission to have pets:	----- Yes No
  Size of Pet allowed:	----- Small Medium Large Extra Large No Limits
  Will Dog Be allowed In the House	----- Yes No
  How long daily will the dog be left alone (without humans)?
  Where will the dog stay when you are away from the house?
  Are you familiar with the use of a dog crate to train the pet:	----- Yes No
  Is your yard fenced:	----- Yes No
  Type of fence (include Height, Width, and Length):
  If you do not have a fence, will you install one:	----- Yes No
  Approximate size of dog's yard area:
  Will the dog be walked daily:	----- Yes No
  Exercised in a fenced yard:	----- Yes No
  Ever allowed to run free without supervision:	----- Yes No
  Will your dog receive formal obedience training:	----- Yes No
  Have you ever had a dog before	----- Yes No
  Are you aware that routine costs average $500/dog/year	----- Yes No
  Ever sold, given away, or surrendered a pet to a shelter:	----- Yes No
  If yes, please specify  why:
  Please tell us why you want a dog:
  Please tell us a little of your lifestyle, your family including any special activities in which your dog would be included.  (If you have any requirements or requests for a dog, please let us know so that we can more carefully match a dog to your lifestyle):
  When you move what will you do with your dog:
  Do you understand the state and local ordinances concerning licensing and leashing:	----- Yes No
  Have you, or any member of your family or household ever been cited for leash law violations or cruelty to animals in the past:	----- Yes No
  If YES please specify:
  When you go on vacation who will care for your dog and where will it be cared for:
  I/we attest that the information provided on this application is true and accurate to the best of my/our knowledge. I/we understand that completion and submission of this application does not guarantee adoption of a dog.
  Applicant's Signature:
  Date:
  Co-applicant's Signature
  Date:
  Your name typed and submitted by email will serve as signature agreement
  Don't forget to call your Veterinarian to give us permission to do a Vet reference check.
  Comments:
  Please Enter The Code:

  
  

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