Dog Adoption Application
Today's Date
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Dog's Name
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Email Address
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Please enter correctly as this is the main way we will contact you
First Name
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Last Name
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Phone Number
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Please use the following format 248-555-1212
Alternate Phone Number
Do you currently:
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Own
Rent
Landlord Name:
Landlord Phone:
Must give Landlord information for us to process application
Do you live in a:
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Townhouse
House
Apartment
Condo
Mobile Home
Other
If you choose "Other" please explain:
Street Address
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City
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County
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State
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Zip Code
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Dogs:
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Cats:
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Pet #1: Name, age, breed
Pet #2: Name, age, breed
Pet #3: Name, age, breed
Pet #4: Name, age, breed
Are vaccines up to date?
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Yes
No
N/A
Are all of your pets spayed/neutered/fixed?
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Yes
No
N/A
Veterinarian's Phone Number
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Name your Vet Records are Under (if different from above)
Veterinarian or Clinic Name
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Other Vet's Name (If you have a second one)
Other Vet's Phone number
Do you have experience with this breed type or similar breeds?
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What if you have to move? What will you do with your pet then?
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Are you aware of the cost of a keeping a pet? These include Food costs, vet costs, grooming, boarding, etc.
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No
Yes
It can take weeks or months for your new pet to become well adjusted in your home. Are you willing to allow this adjustment time?
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No
Yes
What behviors are you NOT willing to work on with your new pet? (select all that apply)
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Hyper
Destructive
Digging
Barking
Aggression
Fearfulness
Housetraining
Other
If you chose "Other" please explain:
Under what circumstances can you not keep this pet?
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Including yourself, how many people live in your household?
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Do you have kids in the home or potential children visitors? Grandchildren? Nieces? Nephews? Neighbors? Please explain:
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Is everyone in your household aware that you are planning to adopt a pet?
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No
Yes
Does anyone in your household have allergies to dogs/cats?
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Yes
No
Possibly
N/A
Where will the animal be kept during the day? At night? Please explain:
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Do you have a completely fenced-in yard? (Not a requirement for all dogs)
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No
Yes
What kind of fence?
How did you find out about us?
Petfinder
Internet Search
Family/Friend
Staff/Volunteer
Facebook
Adoptapet
Other
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.
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Yes
No
name:
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Date:
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