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JBPR Dog Adoption Application
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Are you over 21 years of age and willing to provide a valid form of ID? *
First and Last Name *
Please provide Driver's License Number & Exp. Date
Physical Address *
Cell Phone Number *
E-Mail Address *
Do you have reliable transportation? *
Does everyone currently living in your home agree to adopting? *
Have you adopted a dog before? *
What type of home do you live in?
 *
Do you rent or own your home? *
If you rent, please provide the name and phone number of your landlord below.
If you rent, what do you plan to do if you have to move? N/A if you own *
What are the ages of everyone currently living in your home? *
If you currently have other pets, please list the Type, Size, Gender, and Age of all pets *
Are your pets up to date on vaccinations? *
Are your pets spayed or neutered? *
Please list the name and phone number of your veterinarian. If you do not currently have a veterinarian, leave blank.
Please list 2 personal references that are not family members and their contact information *
Do you have a fenced in yard? *
Describe where your dog may be kept while you are not at home and also where they may sleep. *
Describe a dog that would be a good fit for you. If you are unsure, leave blank.
Please list any relevant animal care or volunteer experience that you have. If no experience, leave blank.
What kind of dog may you be willing and able to adopt? Please check all that apply. *
Required
What is the name  the dog you would like to adopt (if there is one already in mind)
Rescue dogs may come with behavioral problems. (E.g. anxiety, chewing, peeing in the house, aggression, barking, etc.)  In the event your dog may need more training or socialization, would you have the means and support to address these problems? *
Have you ever surrendered or euthanized a dog? Please explain. *
Do you plan to train the dog you adopt? If so, how would you approach training? *
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