ACAS - Dog Adoption Application

To ensure your application is processed quickly, please provide all the required information, including your veterinarian's phone number. This helps us verify pet care history and ensures the best match for our available pets. 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 *
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?	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.
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 N/A
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
Please describe in detail the pet you are looking for.
Please check the main reason you plan to adopt a pet: *	Companion Family Pet Child's Pet Guard Dog Companion for another pet Other
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 N/A
Are your pets current on their vaccinations? *	Yes No Not sure N/A
Have you ever turned your dog or cat into a shelter? *
If yes, please explain?
Have you ever had a pet euthanized? *
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 *
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
How will you handle destructive behavior? *
Will you keep the animal up-to-date on vaccinations? *	Yes No
If no, please explain:
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
If you answered "other" above, please explain:
What will you do with the animal when you go on vacation?	Leave with family/friend Boarding Pet sitter Take with me/us Other
If you answered "other" above, please explain:
For what reason(s) would you consider returning or giving up the animal? *
What would you do with your animal if you had to move? *	Take him / her with me Give to family or friend Return to shelter Other
If you answered "other" above, please explain:
Are you willing to take responsibility for this animal for the next 10-20 years? *
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
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