Request edit access
Pet Adoption Application
Sign in to Google to save your progress. Learn more
Email *
The information provided in this application is true to the best of my knowledge as of the date of the application:  *
Required
Name
Date *
MM
/
DD
/
YYYY
Name of pet interested in adopting?
 *
Address, City, State *
Best contact phone number:
 *
Best contact email: *
Veterinarian Information - Name & Number
 *
Particular type of dog you are looking for?
 *
Do you have a fenced yard? *
If yes, please describe....
If No, what type of containment will you use?
Who will be the primary caregiver?
 *
Who will care for the dog when you are away on vacation?
 *
How many hours will the pet be left alone in a day?
 *
Do you own or rent?
 *
If you rent, please provide name and telephone number of landlord
Where will your pet sleep? *
Do you currently own any pets? *
If yes, please list breed, age, sex, and personality
Have you ever relinquished a dog?
 *
If yes, what was the reason?
Please list names and ages of everyone living in household:
 *
Please list 2 references:
•By clicking the submit button, I agree to The Good Luck Farm. adoption process, will undergo a home check, and interview at the discretion of Good Luck Farm. 

•By clicking the submit button, I understand Good Luck Farm will check my references including veterinary and personal. 

•By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Good Luck Farm. and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet. 

•By clicking the submit button, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify The Good Luck Farm BY EMAIL and provide a 14 day period to allow The Good Luck Farm to make arrangements for my pet to be taken back into rescue. 

•By clicking the submit button, I agree to indemnify and hold harmless The Good Luck Farm against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.  

•By clicking the submit button, I understand that The Good Luck Farm will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed. 

•By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to The Good Luck Farm and provide transport to where The Good Luck Farm deems appropriate.

•By clicking the submit button, I verify all of the above information is true and accurate.  
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms