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? *
Your answer
Contact Information
Please ensure that your contact information is accurate and complete.
Name (First and Last) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Home Address (full address including city and state) *
Your answer
Email *
Your answer
Phone Number *
Your answer
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.
Your answer
Who else lives in your home, and what are their ages and relation to you? *
Your answer
Who will be the primary caretaker? *
Your answer
Will the dog live in your home? *
Your answer
Where will the dog sleep at night? *
Your answer
On average, how many hours will the dog be left alone on a typical day? *
Your answer
Do you have a fenced yard? If yes, how many feet high is your fence? *
Your answer
Are you willing to consent to a home visit? *
Your answer
Work
Some dogs in our care may require more time spent at home than others. We will not contact your employer.
Employment Status *
Name of Employer *
Your answer
Other Pets
What current pets do you own, and what are their types, breeds, ages? *
Your answer
Are your pets up to date on vaccinations and monthly disease preventatives? *
Your answer
Are your pets spayed and neutered? If not, why? *
Your answer
Have you ever surrendered an animal, and if yes, what were the circumstances? *
Your answer
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 *
Your answer
Clinic Name *
Your answer
Clinic Address *
Your answer
Clinic Phone Number *
Your answer
Does your veterinarian have your pet listed under your name, or someone else's? *
Your answer
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? *
Your answer
Do you have any dog training experience? *
What training methods do you have experience with? Please be specific. *
Your answer
Do you have any experience with deaf dogs, blind dogs, or other dogs with special needs? *
Your answer
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 *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
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 *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Relationship *
Submit Form
How did you hear about Keller's Cause?
Your answer
Any additional information you would like to add?
Your answer
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. *
Your answer
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