VIPP Interested Party Application
VIPP Interested Party Application
Animal you are interested in
Cell phone number
Please list contact information for three personal references that are not related to you. Failure to provide this information upfront will invalidate the application.
Do you have other pets at the current time?
If yes, please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?
Are your pets current on their vaccinations?
What other pets have you owned in the last 20 years? What happened to them?
Veterinarian's Name and Contact Information
Have you ever turned your dog or cat into a shelter?
If yes, please explain?
Did any of your pets ever have behavioral issues?
If yes, what were the issues and how did you address them? What was the outcome?
Please check the main reason you plan to adopt a pet
Companion for another pet
Please choose the energy level you are looking for
Please select what is necessary to you in a dog that you would adopt (select all that apply)
Can be left unattended in the home
Will run/jog with me
Good with strangers
Good with livestock
Already knows basic obedience
Can be walked off leash
Likes to fetch/play
Gentle with young children
Likes other dogs
Good with cats
Doesn't pull on leash
Doesn't jump up
Good in car
If other please explain
Please select your current residence type.
Do you own or rent your home?
How long have you lived at this residence?
Landlord name and contact information
If you rent, does your landlord and lease allow pets?
Is your home fenced?
If yes, what is the type and height of the fencing?
Does anyone in your household have allergies to dogs/cats?
Yes dog and cats
Yes cats only
Yes dogs only
Please list the ages and relationship of those who live in your home.
The noise/activity level in my homes is...
If you and/or partner/spouse are employed, what is your current occupation(s)?
How long have you been in this job position?
On average, how many hours per day will your pet be left alone?
Where will the dog stay when you are home?
Where will the dog stay when you are at work or away?
Where will the animal sleep?
Are you willing and able to exercise the dog on a regular basis?
If yes, what is the method of exercise?
Play in Yard
If you answered "other" above, please explain:
How much do you think the annual medical bills will be for your pet?
$100 - $200
$200 - $300
$300 - $500
What would you do if the bills went over this amount?
How will you handle destructive behavior?
How will you handle behavioral issues?
What will you do with the animal when you go on vacation?
Leave with family/friend
Take with me/us
What would you do with your animal if you had to move?
Take him / her with me
Give to family or friend
Return to shelter
If you answered other, please explain
For what reason(s) would you consider returning/giving up the animal?(select all that apply)
Difficult to housetrain
Chews/destructive when left alone
Requires too much exercise
Does not like other dogs
Sick dog/high vet bills
Aggressive with other animals
Are there specific questions you have for us?
Please tell us a bit about yourself and what you are looking for in a doggie match up.
The answers I have given are complete, true and not misleading and I authorize VIPP to contact landlords, references and veterinarians.
Touch Screen Signature ( use touchscreen if available)
Typed Signature (type here if no touchscreen)