Adoption Application
Which dog are you interested in meeting/adopting?
*pending Dandelion (Dog - D2024020)
Applebloom (Dog - D2024030)
Barkley (Dog - D2022068)
Bugsy (Dog - D2024008)
Clove (Dog - D2024022)
Cooper (Dog - D2024026)
Daisy (Dog - D2022074)
Ginger Ale (Dog - D2024031)
Gus (Dog - D2022096)
Jade (Dog - D2024025)
Kya (Dog - D2024018)
Little Ricky (Dog - D2024007)
Nova (Dog - D2024032)
PENDING Axl (Dog - D2024009)
Scootalo (Dog - D2024029)
Trixie (Dog - D2024028)
Zeke (Dog - D2024033)
Ziggie (Dog - D2024034)
Please list ALL dog(s) you're interested in -
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How did you hear about us?
First Name
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Last Name
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Email
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Home Address
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City
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State
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Zip Code
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Home Phone
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Work Phone
Cell Phone
Best Time to Call
Are You Over 21 Years Old?
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No
Yes
Hours Worked Per Week
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Number of People Living in Household
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Is everyone living in the household in agreement about adopting the dog?
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No
Yes
Members of Household: Please list names, relationship and age.
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Whose responsibility will it be to feed, water and care for the dog?
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Do you anticipate any significant changes in the next year? Check all that apply
New Baby
Move to an Apartment
Move to a House
Job Changes
Relocation
Military Service/Deployment
Other
What plans would you have for the dog if any of the above occur?
Do you have a long-term plan in place if you were no longer able to care for the dog or if the dog outlives you? (Please explain)
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Please list any current pets you have, name, type, age, spayed or neutered, length of time owned and if they are current on vaccinations?
What brand of heartworm prevention are your current dogs on?
Do your other pets get along with dogs?
No
Yes
Are you willing to have your current dog(s) meet the new dog?
No
Yes
Have you had any other pets in your adult life?
No
Yes
IF YES, how long did you own them and what happened to them?
What kind of traits are you looking for in a dog?
What do you consider undesirable traits?
What breed / mix do you prefer?
Do you have prior experience with these breeds during your childhood or as an adult? If so, please explain:
What is the approximate adult weight of the dog you are looking for?
What is the activity level of the dog you are looking for?
What gender do you prefer?
Male
Female
No Preference
Reason for gender preference?
Would you be willing to housetrain / crate train your new dog?
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Yes, if necessary
No, needs to be housetrained already
Do you need for your new dog to be good with children?
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No
Yes
What type of home do you live in?
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House
Apartment
Condo/ Townhouse
Other
IF OTHER, please explain:
Do you own or lease?
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Own
Lease
IF LEASING, do you have permission to own a pet? (Proof of pet deposit and / or landlord approval will be required)
No
Yes
IF LEASING, are you aware of any pet restrictions?
No
Yes
IF RESTRICTIONS, please explain:
Landlord Name
Landlord Phone Number
Is your yard SECURELY/FULLY/PROPERLY fenced?
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No
Yes
IF YES, what type of fence is it? Check all that apply:
Chain Link
Wood Privacy
Farm Fencing or Welded Wire
Electric/Invisible Fencing
Wrought Iron
Other
IF OTHER, please describe:
What is the height of the fence?
Do you have a swimming pool?
Yes (Fenced)
Yes (Unfenced)
No
How many hours a day do you plan to share with the dog?
What role will this dog play in your life? Check all that apply:
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Companion for Me
Protector / Watchdog
Company for Other Dog
Jogging Buddy
Friend for Child / Children
House Pet
Gift
Outside Dog
Other
IF OTHER, please explain:
What activities do you plan to share with the dog?
What training are you interested in doing with the dog?
Basic Obedience
Advanced Obedience
Flyball / Agility
Therapy Dog
Where will the dog be kept during the day? Check all that apply:
Inside the House
Day Care
Crated
Fenced Yard
Kennel or Run
Loose in Unfenced Area
Tied Outside
Garage
Other
IF OTHER, please explain:
Where will the dog be kept at night? Check all that apply:
Inside the House
Crated
Fenced Yard
In a Kennel or Run
Loose in Unfenced Area
Tied Outside
Garage
Other
IF OTHER, please explain:
Who will care for the dog when you travel or problems occur that make you unavailable?
How will you transport the dog?
Loose in Car
Seat belted in Car
Crated in Car
Inside Cab of Truck
What brand of food will the dog eat?
On average, how much do you expect to spend annually on this dog? (including food, routine and emergency vet care, grooming, toys etc.)
Heartworm Information Heartworms are parasites transmitted by mosquitoes to your dog. They live and grow in the heart, eventually producing enough worms that the heart can no longer function and the dog dies. Treating a dog for heartworms is both expensive ($500-$1000) and very hard on your dog’s system because the treatment used to kill the worms can be fatal. Heartworms are, however, very easily prevented with a monthly heartworm preventative. Your dog will need to be on heartworm prevention for the rest of its life. Are you willing to commit to this level of care?
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No
Yes
At minimum the dog will require a yearly vet exam and vaccinations. Often dental care and other procedures may be required. Are you committed to this level of care for the rest of the dog’s life?
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No
Yes
There are times when unexpected and often very expensive medical conditions occur. Are you committed to providing whatever medical care your veterinarian deems necessary for you dog?
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No
Yes
Veterinarian
Veterinarian’s Phone Number
What will you do if the dog displays bad behavior such as barking, digging, chewing, etc?
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What would you consider a legitimate reason for “giving up” a dog?
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