Adoption Application Online

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number(s) *

Email *

Household Information

Please lists all adults and children in the home, along with their ages *

What type of home do you live in? *

How long have you lived in this home? *

Is your yard fenced in? If so, what type of fencing do you have and how high is it? *

How would you describe your household? *

Do you own or rent? *

If you rent, please provide the landlords name and number

Information on pets in the home and previous pets

Please provide a list of all the pets in your home, along with their ages *

For each pet listed above, state their status on vaccines, heartworm prevention and if they are spayed or neutered *

Have you ever surrendered a pet? If so, explain why *

Have you ever had a pet euthanized? If so, explain why *

Have you ever lost a pet to an accident? *

How do you discipline your pets and why? *

What experience do you have training dogs and do you plan on taking obedience classes? *

Vet Info

Vets Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

About the pet you wish to adopt

Please provide the pets name you are interested in (if applicable)

What is your idea of an ideal dog? *

Desired age of dog *

Desired size of dog *

Desired breed *

Is there a breed you would not adopt and why? *

Desired Sex *

Which of the following are you willing to adopt? *

Where will the dog spend its days? *

Where will the dog spend its nights? *

Where will the dog stay when you are not home? *

Average number of hours the dog will be home alone *

Who will have primary responsibility for the dog? *

Will the dog spend most of its time being an outdoor dog or an indoor dog?

Outdoor
Indoor

References

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Numbers *

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Numbers *

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Numbers *

Name of person completing the application *

Date / Time *

Date

Time

Website