Adoption Application

* Name of animal interested in

* First Name

* Last Name

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

* Email Address

Age

Occupation

Names and ages of others living in

household and their relation to you

What type of animal are you looking for (check all that apply):

If this pet is for a gift, for who?

Do you own or rent

Do you live in

If renting do you have landlords permission to have a dog/

if so please provide landlords name and phone

Is there fencing and if so what is the type and height of fencing?

If you do not have a fence please explain how you will handle your dog or puppy's bathroom & exercise?

Please list all pets currently living with you.

Any additional pets and please list the animals you have had in the past (do not include family pets from childhood):

How many hours will your Dog be left alone during the day?

Where will the dog be kept when alone?

How will you exercise your dog?

Does anyone in your family have allergies to dander/hair?

Who is your Veterinarian/Clinic?

How much will you spend if your dog became ill?

How much time do you have each day to exercise/ play with your dog?

What will you do with your dog if you have to move?

Have you ever had to give up a Pet (Dog/Cat/Other) for any reason? If yes please explain.

Dogs can dig, chew, bark, jump up on people and bite. How do you plan to deal with these or any other potential problems?

What reasons would cause you to return the dog to us?

Is there anything else you would like to tell us about you or do you have any questions for us?

* Indicates Response Required