AWL Dog Adoption Application
Animal you are interested in adopting
Billy (Dog - 234218)
Carol (Dog - 234175)
Cassia (Dog - 234180)
Debbie (Dog - 234214)
Dottie (Dog - 224080)
Doug (Dog - 224130)
Freddie (Dog - 234213)
George (Cat - 224156)
Greg (Dog - 234170)
Kobe (Dog - 234202)
Minerva (Cat - 234208)
Pandora (Cat - 234227)
Patsy (Cat - 234228)
Peter (Cat - 234229)
Prissy (Cat - 223788)
Splash (Cat - 224109)
Squirt (Cat - 234211)
Winnie (Dog - 234200)
Yoda (Cat - 234210)
Applicant's First Name
Applicant's Last Name
Street Address
City
County
State
Zip Code
Phone Number
Alternate Phone Number
Email Address
Please select your current residence type.
House
Apartment
Condo
Townhouse
Mobile Home
Farm
Other
If you answered "other" above, please explain here:
Do you own or rent your home?
Own
Rent
Someone else owns the Home
Someone else rents the Home
If you rent, does your landlord and lease allow pets?
Yes
No
Unsure
N/A
Do you live in someone else's home?
No
Yes
Where will you keep this dog:
Indoors
Outdoors
Both
Do you have a cat/dog door that goes outside?
No
Yes
When outdoors, will it be kept:
*
Other
Wood fence
Chain Link
If you answered "other" above, please explain:
When outdoors, what kind of shelter will it have? Explain:
Do you plan to crate train your dog for times when you are not at home?
No
Yes
Where will your dog stay during the day?
Inside
Outside
Both
Where will the animal spend the night?
In bed with me
In bed with my child
In a dog / cat bed
In a kennel / crate
Wherever he or she likes
Outside
Other
If you answered "other" above, please explain:
On average, how many hours per day will your pet be left alone?
Which members of your household have raised a dog?
Does anyone in your household have allergies to dogs/cats?
Yes
No
Possibly
N/A
Please list the names, ages & relationship of those who live in your home, including yourself.
Which family member will be responsible for the dog's care and training?
What kind of pets have you had in the past?
Where are they now/ what happened to them?
Do you own other pets at the current time?
No
Yes
If yes, please list their names, breeds, and ages.
Are all of your pets spayed or neutered?
Yes
No
N/A
Are all your pets current on their vaccinations?
Yes
No
n/a
Because we have such a high rate of Heartworm in dogs in our area of Arkansas, what do you use to prevent heartworm in dogs you have had in the past?
*
What provisions will you make for the dog should you become unable to care for him/her?
Veterinarian's Name
Veterinarian's Address, City, State, and Zip Code
Veterinarian's Phone Number
Do you agree to return the dog to AWL if things don't work out?
No
Yes
I understand that by adopting a dog I am making a long-term commitment (possibly 15-years) to this pet and all the related expenses, including veterinary care and emergency care. I submit the above information as true and accurate to the best of my knowledge.
Yes
No