First Name *
Last Name *
Email *
Address *
City *
State *
Zipcode *
Home/Cell Phone *
Occupation/Employer *
Adoption Questionnaire
Please answer all questions to the best of your ability.
What animal(s) are you interested in adopting? *
Amber (Dog - D2024027)
Graycee (Dog - D2024026)
Hunter (Dog - S2023046)
Midnight (Dog - D2024021)
Molly (Dog - S2024006)
Penelope (Dog - D2024011)
Rio (Dog - D2024020)
Rosie (Dog - D2022009)
Rumble (Dog - D2023005)
Sadie (Sunny) (Dog - D2024016)
Sheba (Dog - S2024200)
Skittles (Dog - D2023087)
Solavina (Dog - D2023025)
Winnie (Dog - S2024201)
Zak (Dog - D2024028)
If the dog or puppy you are interested in is unavailable, would you be interested in hearing about another? *
No Yes
How many people live in your household? What are the AGES for the people that live in your home? *This is important to determine if a pet is a good match for your family. *
Are there any people in your household with special needs? *
No Yes
Type of home you reside in? *
House Condo Apartment
Do you own or rent your home? *
Own Rent
If you rent, did you receive the approval of your landlord to have a pet? *
Yes
No
NA
Please provide your landlord's name and phone number OR mark NA if not applicable *
Length of time you have been at this address? *
Is your yard fenced? If so, what TYPE of FENCING, what is the HEIGHT? *
Do you belong to a Homeowners Association (HOA)? If yes, please provide their name and contact information. How many pets are you allowed to have?
How much time will the pet be spending ALONE during the day? *
Where will the animal be kept when left alone? e.g. crate, loose in house, confined to a room, outside in yard *
Where will the pet sleep? e.g. crate, pet bed, owner bed, inside/outside *
Describe how you will train the pet *
Have you ever had to surrender or re-home a pet? If "yes," please explain *
Do you have other pets? If so, please describe (Name, type, age, sex, breed, spayed/neutered) *
REQUIRED: Please provide your veterinarian’s name and telephone number (Vet that provided your Past & Current pets' vaccinations/Heartworm preventative). Please list pet's name(s)(PAST & CURRENT) & the name that account is under if different from application. Also, please call your vet to give permission for us to obtain information. *LACK OF INFORMATION, COULD DELAY YOUR APPLICATION PROCESSING. *
Are your cats and dogs current on their vaccinations, rabies and heartworm protection? *
Yes
No
NA
What happened to your previous pets, if applicable?
Explain the type of exercise, and the frequency, that will be provided for the pet. *
Have you ever been convicted of a felony? If yes, please explain. *
Please provide 2 personal references & contact #, that are not related to you: *
(OPTIONAL) Feel free share a little about you and/or your family and the life you would provide for this pet, should you be chosen.
I certify that the information on this application is true. I give permission for you to contact my personal references, HOA, landlord and veterinarian's office. Please sign your name here. *
Please enter today's date. *