ACAS - Dog Adoption Application

Adopting a pet is a legally binding, multi-year financial and personal commitment—not a trial run. Every animal requires dedicated training, time, and money for routine and emergency care. If you have not researched the specific breed traits, energy requirements, and true annual costs of pet care, please do not submit this application until you have done so. Thank you.

Animal you are interested in adopting
Animal you are interested in adopting if more than one. Additional animal that you may be interested in adopting or wanting to adopt a bonded pair.
Applicant's First Name *
Applicant's Last Name *
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.
Street Address *
Apartment Number (if applicable)
City *
State *
Zip Code *
PHOTO ID *
How long have you lived at this address? *
What type of home do you live in? *	Apartment/Condo Mobile Home Townhouse/Duplex Single Family Home
Do you own or rent your home? *	Own Rent
If you rent, does your landlord and lease allow pets? * We will need to contact your landlord to confirm that they do allow pets and if they have limitations on breed or size.	Yes No
Name and contact information for your landlord or apartment complex.
What would you do if you encounter housing issues or landlord restrictions? *	Work with landlord Move to pet-friendly housing Return animal to shelter
Including yourself, how many people live in your household? *
In the event of a breakup, divorce or roommate separation, who assumes 100% legal and financial responsibility for this animal? *	I am the sole owner and will retain the pet regardless of any relationship changes, housing shifts or moving situations. My partner/roommate and I have clear plan for who keeps the pet if we separate, and it will NOT be returned to the shelter. _____________________________________________ We have not discussed or agreed on this yet. (Please note: Applications selecting this option will require additional staff review prior to approval.)
Please list the ages of those who live in your home.
How would you describe your household energy level? * When describing the energy level of your household on an adoption application, you'll want to be honest and clear. This helps ensure the right pet is matched with your home!	Active Household - fairly active, with frequent walks, playtime, and have a lot of energy to devote to a pet. ___________________________________________ Moderately Active Household - moderately active household, outdoor activities and regular walks, with plenty of downtime. ___________________________________________ Calm and Relaxed Household - household is relatively calm, relaxed, with plenty of quiet time for a pet to feel comfortable. Daily routines and occasional activities, value rest and relaxation." __________________________________________ Balanced Household - household has a balanced energy level, with a mix of active times, quiet, restful moments. Home is peaceful but has the excitement of regular walks, play, and socializing. __________________________________________
Does anyone in your household have allergies to dogs/cats?	Yes No Possibly
What size dog are you looking for?	Toy breed - up to 15lbs Small breed - between 20-30lbs Medium breed - between 35-60lb Large breed - between 60-90lb Extra Large breed - over 90lbs Open to any size dog
What would you do if you encounter behavioral issues (housebreaking accidents, destructive chewing, barking, reactivity, hiding and such issues)? *	Commit 30-90 days to training Hire a certified pet trainer Return animal to shelter
Please check the main reason you plan to adopt a pet: *	Companion/Family Pet Child's Pet Guard Dog Companion for another pet
If you seleted other, please describe in detail the pet you are looking for.
Do you own other pets at the current time? *	Yes No
If you have pets, will they adjust to a new pet in the house? *	Yes No Unsure N/A
If yes, please list their names, breeds, ages, and how long you have had them.
How many pets have you owned in the last 5-10 years? *
What happened to them? *
Are all of your pets spayed/neutered/fixed? *	Yes No
Are your pets current on their vaccinations? *	Yes No
Have you ever turned your dog or cat into a shelter? *	Yes No
If yes, please explain?
Have you ever had a pet euthanized? *	Yes No
If yes, please explain:
Veterinarian's Name * If you have never owned a pet please tell us where you would go.
Name on the account at the veterinary clinic. *
Veterinarian's Phone Number *
What would you do if you have unexpected vet bills or medical needs? *	Utilize savings Apply or use Care Credit or pet insurance Return to shelter
How many hours a day will the dog be left alone? *
How will the dog spend their alone time? * Please check all that apply.	Free roam inside Kenneled or crate trained inside Outside free roaming within a fenced area Outside in a kennel or pen Outside on a tie out Dog day care or boarding facility
Will this pet be predominantly living inside, outside, or both? *	Inside Outside Both
What type of yard security do you have? *	Chain Link Privacy Electric Tie Out No Fence
Will the dog be tied up outside? *	Yes No
Will you keep the animal up-to-date on vaccinations? *	Yes No
What arrangements will you make for the care of your pets in case of an emergency?	Leave with family/friend Boarding Pet Sitter Take with me/us Other
What would you do if you encounter lifestyle changes (new job, work travel, schedule change, new baby)? *	Adjust daily routine, schedule and keep the pet. Work with a trainer, day care facility or pet sitter for my pet. Return animal to the shelter.
What would you do with your animal if you had to move? *	Take him / her with me to pet friendly housing Give to family or friend Reach out to rescues and rehoming sites Return to shelter
I understand that a breakup, divorce, or household split is NOT an acceptable reason to surrender this pet. By submitting this application, I confirm that I am taking on full, multi-year responsibility for this animal regardless of changes in my personal life or relationship status. *	Yes, I understand and agree. No, I do not understand or agree.
Our goal is permanent placement. Adopting an animal requires time, patience, and a multi-year commitment. If you are looking for a temporary trial or are unsure if your schedule and lifestyle can accommodate a pet right now, please delay applying until you are 100% ready. *	Yes, I am 100% ready. No, I am not 100% ready but please keep my application on file for when I am.
Are you willing to take responsibility for this animal for the next 10-20 years? *	Yes No
If no, please explain:
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.	Yes No
Signature