Dog/Puppy Adoption Application

Name of animal you are interested in adopting *
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
Province *
Apartment Number (if applicable)
Postal Code *
Phone Number * Please use the following format 248-555-1212
Email Address * Please enter correctly as this is the main way we will contact you
How did you find out about us? *	Internet Search Family/Friend Staff/Volunteer Facebook/Kijiji
Is this pet for you or someone else? *	Myself Someone else
Do you own other pets at the current time? *	NoYes
If yes, please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?	Yes No N/A
How many pets have you owned in the last 5-10 years?
Are your pets current on their vaccinations?	Yes no n/a
Personal Reference 1 name and relationship (non-family member) *
Reference1 phone number *
Personal Reference 2 name and relationship (non-family member) *
Reference 2 phone number. *
Veterinarian's Name If you have never owned a pet please tell us where you would go.
Do you own or rent your home? *	Own Rent Someone else owns the Home Someone else rents the Home
How long have you lived at this address? *	Less than one month 1-2 months 3-6 months 6-9 months 9-12 months 1-2 years 3-5 years 6-10 years 10 + years
If you rent, does your landlord and lease allow pets?	Yes No Unsure N/A
Including yourself, how many people live in your household? *
Please list the ages & relationship of those who live in your home. *
Is everyone in your household aware that you are planning to adopt a pet? *	Yes No N/A
Employment Status *	Full-Time Part-Time Retired Work from Home Stay at Home Parent Student Unemployed Other
If you chose "other" above, please explain:
If you are employed, what is your current occupation? *
Do you have a fenced yard? *	NoYes
If yes, what type of fence and how tall is it?
Will this pet be predominantly living inside, outside, or both? *	Inside Outside Both
Please provide a description of this pet's living conditions. *
Are you willing to take the dog to obedience classes? *
Will you keep the animal up-to-date on vaccinations? *	NoYes
Please provide any additional info you think will assist in the application process.
All the information indicated above is correct to the best of my knowledge (please sign below). *	Clear