Keller's Cause Dog Adoption Application
Thank you for your interest in adopting a dog from Keller's Cause! Our application process is not first come, first served, and we work tirelessly to make sure each dog is placed with the absolute best match for that individual dog. If you have any questions about our application process or dogs in our care, please feel free to contact us through our website or Facebook page.

***Please note that if your address is incomplete, or your references are empty, we will not process your application.
We do advise reaching out to your references and vet to let them know they may be contacted. Some vets require client authorization before they will speak to a rescue.***
Which dog are you interested in adopting? *
Contact Information
Please ensure that your contact information is accurate and complete.
Name (First and Last) *
Date of Birth *
MM
/
DD
/
YYYY
Home Address (full address including city and state) *
Email *
Phone Number *
Family & Home
What type of home do you live in? *
Do you own or rent your home? *
If you rent, please provide your landlord's name and phone number.
Who else lives in your home, and what are their ages and relation to you? *
Who will be the primary caretaker? *
Will the dog live in your home? *
Where will the dog sleep at night? *
On average, how many hours will the dog be left alone on a typical day? *
Do you have a fenced yard? If yes, how many feet high is your fence? *
Are you willing to consent to a home visit? *
Work
Some dogs in our care may require more time spent at home than others. We will not contact your employer.
Employment Status *
Other Pets
Name of Employer *
What current pets do you own, and what are their types, breeds, ages? *
Are your pets up to date on vaccinations and monthly disease preventatives? *
Are your pets spayed and neutered? If not, why? *
Have you ever surrendered an animal, and if yes, what were the circumstances? *
Veterinarian Information
If your application is considered for a specific dog, we will contact your veterinarian to verify the medical information provided.
Veterinarian's Name *
Clinic Name *
Clinic Address *
Clinic Phone Number *
Does your veterinarian have your pet listed under your name, or someone else's? *
Adopting a Special Needs Dog
A majority of the dogs under the care of Keller's Cause have special needs. Please answer a few questions to help us get to know you better. Note that experience is not required, but will help us decide whether or not specific dogs may be a good fit for your home.
Why are you interested in adopting a dog with special needs? *
Do you have any dog training experience? *
What training methods do you have experience with? Please be specific. *
Do you have any experience with deaf dogs, blind dogs, or other dogs with special needs? *
Personal Reference #1
Please provide two personal or professional references who are familiar with you as well as your pets. Please notify your references that you have submitted their information, as we may contact them.
Name *
Phone Number *
Email Address *
Relationship *
Personal Reference #2
Please provide two personal or professional references who are familiar with you as well as your pets. Please notify your references that you have submitted their information, as we may contact them.
Name *
Phone Number *
Email Address *
Relationship *
Submit Form
How did you hear about Keller's Cause?
Any additional information you would like to add?
What is your preferred method of contact? *
By printing your name below, you consent that all of the above information is true to the extent of your knowledge. *
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