Dog/ Puppy Adoption Application

Animal Name *

Animal name if it did not appear in drop down

First Name

Last Name

Applicant date of birth *

Address *

City *

State *

Zip *

Home (or alternative) Phone *

Work Phone

Cell Phone *

Employer *

Email

How long have you lived at your current address? *

Previous address if less than 2 years at current address

Do you own or rent? *

If you rent, are there pet restrictions?

If you rent please provide your landlords name & phone number:

Please list all family member(s) name(s), and date of birth that live IN your home. *

Please list the children living in the home and their age(s):

Please list all of your current pets including names, ages, m/f, if altered, and how long you have owned them.

Have you ever been issue a citation for your pet or had to reclaim your pet from animal control/shelter *

If yes, please explain

Have you ever turned in your animal to local animal control or given up an animal? *

If so, what was the reason?

Do you have a criminal record or a felon? *

If yes, please explain

Do you have a fenced in yard? *

How high is the fence?

*If you do not have a fenced in yard, are you prepared to walk your dog multiple times a day in spite of weather conditions?

Who will be the primary caretaker of your animal?

Is this your first dog?

Explain any special experience, training or qualifications you may have that would increase the likelihood of you being a great dog owner.Example; previous foster or rescue experience, experience with a special needs animal, professional training history , work at a vet office…

How many hours during the AVERAGE day will this dog spend WITHOUT a human?

Where will this dog be when alone? *

Where will this dog sleep at night? *

If kenneled, how many hours a day will the dog spend in a kennel?

What is your current lifestyle like( active, busy, travel frequently, etc.) *

Does anyone in your home have any type of allergies to animals? *

If yes, who? And how will this be handled to the best interest of your family member and pet?

If you have to move, what would you do with your adopted pet? *

What circumstances would you have to surrender your pet? Divorce? New Baby? Allergies?Aggression? Housebreaking issues? Please explain... *

Dogs need 3 months to feel comfortable in a new home, they need 3 months to truly form a bond with the members of the family. They need three months to understand your routine. Will you give your dog this adjustment period before misjudging undesirable behaviors? *

Do you plan to enroll your adopted dog into obedience class? *

Can you financially afford veterinarian costs for your adopted dog? Emergency cost? *

In the event of extreme illness or death, who will assume the care of your pet(s)? Including name and phone number. *

Personal Reference#1- NOT FAMILY

Telephone number and best time to call *

Relationship *

Personal Reference #2- NOT FAMILY *

Telephone number and best time to call: *

Relationship *

Vet Name *

Address *

City *

State *

Zip *

Phone *

Signature

Date *