Dog Adoption Application

First Name *
Last Name *
Spouse / Partner Name:
Address * No PO Boxes
City *
County *
State *
Zip Code *
Phone *
Email Address *
What is your birthdate? *
How long have you been at your current job? * If not employed, enter n/a
Names and ages of all people in your household *

Housing *
Housing Type *
If you rent, please list landlord name and contact information.
What is the general noise and activity level in your home? *

Which dog are you interested in? Choose from the dropdown menu. If undecided, leave blank.
Is there second dog you are interested in? Choose from the dropdown menu. If undecided, leave blank.
Is this the first time you have owned a dog? *
What are you looking for in a new dog? *
Please list your other pets by name, type and age Enter n/a if no other pets
Tell us about your other pets at home, including any training. Are they active, mellow, well behaved, or party animals?
How long are your pets alone each day? *
Would you consider doggie daycare, hiring a dog walker, or having a trusted friend come over to let your dog outside if you are away for 8+ hours each day? *
Where would your dog sleep at night? *
Where will you keep your new dog when you are away from home? *
Do you have a fenced-in yard? *
If yes, what type of fence do you have? *

Who is your veterinarian? Please list name of current and previous clinics and phone numbers. *
Are your pets up to date on vaccines? *
Are your pets spayed or neutered? *
Are your dogs on Flea, Tick and Heartworm prevention? If you do not currently have dogs, would you provide Flea, Tick, and Heartworm prevention? *
How would you handle medical issues for your dog? *
If you or a family member developed allergies to the dog, what would you do? *
What reasons would you give up your dog? *
What information can we give you to ensure a successful adoption?
Is there anything else you want us to know to help us find the best dog match for you? This will give you a chance to describe in more detail what you are looking for with a new dog!

Attach State Issued Photo Identification Drivers License or ID Card - NO Federal / Military ID's Allowed. You will need to present this identification at the time you pick up your new pet.
Type YES to indicate that you understand and agree that adoption fees are considered a donation and will NOT be refunded. *

Signature * By completing and submitting this legally binding contract, Adopter certifies that Adopter has read, understands, and fully agrees to same.