Adoption Application

Which dog are you interested in adopting?

Are there other dogs that interest you? *

Applicant's First Name *

Applicant's Last Name *

Date of Birth *

What is your employment status *

If you are employed, what is your current occupation? *

Do you have a spouse/Significant Other/Partner? *

Spouse/Significant Other First Name *

Spouse/Significant Other Last Name *

Spouse/Significant Other Date of Birth *

Spouse/Significant Other/Partner's Employment Status *

If they are employed, what is their current occupation? *

Street Address *

Apartment Number (if applicable)

City *

State *

Zip Code *

Email Address *

Home Phone Number

Cell Phone Number *

How did you find out about us? *

Do you own or rent your home? *

If you rent, does your landlord and lease allow pets? *

Please select your current residence type. *

If you answered "other" above, please explain here: *

How long have you lived at this address? *

Will you allow us to perform home checks? *

Including yourself, how many people live in your household? *

Are there children (17 and under)living in your home? *

If yes, what are their ages? *

Is there anyone else living in the home that is 18 years or older? *

Please list all the adults in your home over that age of 18 years. Please include their date of birth (mm/dd/year) *

Do you have children who regularly visit your home? *

Please list the ages of all children who visit regularly *

Is everyone in your household aware that you are planning to adopt a pet? *

Does anyone in your household have allergies to dogs/cats? *

Do you have a completely fenced-in yard? *

If yes, what type of fence? *

If you answered "other" above, please explain: *

How high is the fence? *

If you do not have a fenced yard, how will you let the animal out? *

Do you have a pool? *

Is there a fence around the pool? *

What kind of fence do you have around your pool? *

If you answered "other" above, please explain: *

Do you Currently own any pets? *

Please list all of the pets you currently own. This should include, Pet's name, Species, Breed, Age and how long have you had the pet. *

Are all of your pets spayed/neutered/fixed? *

If you answered no to the previous question, please explain: *

Are your pets current on their vaccinations? *

If you answered no to the previous question, please explain: *

Are all of your dogs tested for heartworm on a yearly basis? *

If you answered NO to the previous question, please explain: *

Are they given a monthly heart worm preventative? *

If you answered no to the previous question, please explain:

Are your pets used to being around other animals? *

Were any of your pets obedience trained? *

If yes, please provide details *

Please list all of the dogs that you have owned as an adult and indicate why the dog is no longer with you. Please include: Name, Breed, How long did you own the dog, why you no longer have the dog- Deceased (old age) or Deceased (other) *Do not include current dogs that you currently own or those you had as a child. *

Have you ever had a pet euthanized? *

If yes, please explain: *

Have you ever turned your dog or cat into a shelter? *

If you answered yes to the previous question, please explain: *

Have you ever had to re-home a pet? *

If yes, please explain the circumstances and any steps you took (if any) to try to keep the pet living with you. *

What characteristics are you looking for in your new dog? *

On average, how many hours per day will your newly rescued pet be left alone?Please provide details if needed. *

If your newly rescued pet will be alone for more than 9 hours, will you have someone to come take care of the dog? *

How much do you think the annual medical bills will be for your pet? *

What would you do if the bills went over this amount? *

Would you consider adopting a dog with special needs? (One that is required to have medication or special training) *

If you answered no to the previous question, please explain: *

Would you consider adopting a dog with medical needs (such a heartworm) and seeing the dog through treatment at the rescue's expense? *

If you answered no to the previous question, please explain: *

Where will the animal sleep?

If you answered "other" above, please explain: *

Are there times when the animal will be tied/chained up? *

If yes, when will they be tied/chained up? *

Please provide a description of this pet's living conditions. *

Please check the main reason you plan to adopt a pet: *

If you answered "other" above, please explain here: *

The Davis Dog Farm dogs are located throughout the tri-state area. You may have to travel within that area to pick up your dog. Are you willing to travel if required? *

Training is a requirement for most Davis Dog Farm dogs. This can be done via group classes or in-home training. Are you willing to attend training sessions with your new dog? *

The Davis Dog Farm operates by matching dogs with families using the information obtained from your application, home visits, references and lifestyle, as well as The Davis Dog Farm evaluation of the dogs in our care and their needs. You may not be matched with the first dog that interests you. Are you willing to wait for the dog who is the best match for your family? *

Applicants are not always matched with the first dog that interests them. Would you like us to contact you if another dog that matches your interests becomes available? (If so, you will need to answer a few questions for us to keep on file) *

What age range are you interested in for a dog? (please select all that apply) *

What sex are you looking for? *

What size dog are you looking for? (please select all that apply) *

What color preference do you have for a dog? *

Do you have a breed or breed mix preference? (Please keep in mind that almost all rescue dogs are a mix of breeds and we cannot guarantee specific breeds or mixes) *

Is there another breed or breed mix you like? *

Do you prefer a dog that is tested to be good with kids? *

Do you prefer a dog that has been tested well with Cats? *

Do you prefer a dog that is already housetrained? *

Do you prefer a dog that has been tested well with other dogs? *

Is there any other information that you would like us to keep in mind when matching you with an animal?

Please list any additional information that you would like to share and/or questions you may have.

Have you owned a pet in the last 5 years? *

Veterinarian's Name *

Veterinarian's Address, City, State, and Zip Code *

Veterinarian's Phone Number *

Personal Reference #1- Name *

What is your relationship with this reference (can be a family member)? *

Personal Reference #1-Address *

Personal Reference #1- Phone Number *

Personal Reference #1- Email *

Personal Reference #2- Name *

What is your relationship to this reference (cannot be a family member)? *

Personal Reference #2- Address *

Personal Reference #2- Phone Number *

Personal Reference #2- Email *

Personal Reference #3- Name *

Personal Reference #3- Relation (cannot be a family member) *

Personal Reference #3- Address *

Personal Reference #3- Phone Number *

Personal Reference #3- Email *

Have you ever been convicted of abuse or neglect of a child or animal? *

If yes, please explain: *

We require background checks for all of our adopters and anyone 18 years or older living in the home, Do you agree to The Davis Dog Farm performing a background check prior to being approved to adopt?. If you have copies of your current PA Child Abuse History Clearance and the PA State Police Criminal Record Check, please email them to info@davisdogfarm.com *

I (We) attest that the information provided is true and accurate to the best of my (our) knowledge. I (We) understand that the completion and submission of this application does not guarantee and adoption of a dog from The Davis Dog Farm. I (We) agree o the requirements for adoption through The Davis Dog Farm and agree to their stated terms of adoption (including the home visit prior to approval). I (We) authorize The Davis Dog Farm to contact landlords, references, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal. *