Adoption Application
First Name *
Your answer
Last Name *
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Phone *
Your answer
Email *
Your answer
Do you own, rent or lease your home? *
If you rent of lease your home, please provide your landlord's contact information
Your answer
Landlord Name
Your answer
Landlord Phone Number
Your answer
Landlord Email
Your answer
Do you have a securely fenced yard with a visible/physical fence? *
Invisible or electronic fences are not acceptable due to safety reasons. If you have an invisible fence, please re-apply once you have build a full 6 foot fence.
How high is your fence?
Do you have a separately fenced dog run area?
If yes, how high is that fence?
Your answer
If/when a suitable dog becomes available, may a 4 Paws 2 Freedom representative visit your home by appointment with you to verify that you have a securely fenced area?
Does your home have a pool, pond or other body of water?
Does any person in your home have special needs?
If yes, please describe
Your answer
Are you a veterinarian?
Are you a vet tech?
Are you a dog trainer/behaviorist?
Do you hold any other profession related to dogs? If yes, please explain
Your answer
Including the applicant above, how many adults live in your home?
Your answer
If children live with you or children visit your home regularly, please indicate how many are in each of the age groups below:
Column 1
Row 1
0-6
Your answer
7-10
Your answer
11-13
Your answer
14-17
Your answer
Is anyone in your home allergic to dogs?
Have you ever taken a dog through a dog training class or done any other formal dog training?
If yes, what is the highest level taken?
Are you comfortable obtaining and using a dog crate?
How many total hours per day, on average, would a dog be alone(without adults present)?
Where would the dog be when home without adults present?
Where would the dog be at night?
Do you have a dog currently?
How do you plan to exercise your dog?
How often do you plan to exercise your dog?
Your answer
Which sex are you interested in adopting?
Is there a particular Career Change Dog you are interested in adoption?
Your answer
Please tell us about any dogs currently living in your home at this time.
Your answer
Breed of dog
Your answer
Sex
Spayed or neutered
Indoor or Outdoor dog
Age
Your answer
Dog 2 Currently Living in Home
Breed of Dog
Your answer
Sex
Spayed or neutered
Age
Your answer
Indoor or Outdoor dog
Dog 3 Currently Living in Home
Breed of Dog
Your answer
Sex
Spayed or Neutered
Age
Your answer
Indoor or Outdoor dog
Do you currently own any cats?
Do you currently own any rabbits or other small mammals?
Do you currently own any caged birds?
Do you currently own any horses?
If you own any other type of aminal, please specify.
Your answer
Please tell us about any dogs you have had previously as an adult
Your answer
Breed of Dog
Your answer
Sex
Spayed or neutered
Indoor or outdoor dog
How long did you own that dog?
Your answer
What became of that dog?
Your answer
Dog 2 Previously had as an adult
Breed of dog
Your answer
Sex
Spayed or Neutered
Indoor or outdoor dog
How long did you own the dog
Your answer
What became of that dog
Your answer
Dog 3 Previously had as an adult
Breed of dog
Your answer
Sex
Spayed or neutered
Indoor or outdoor dog
How long did you own that dog
Your answer
What became of that dog?
Your answer
What is the minimum age (youngest) puppy or dog that you want to consider? Please select one.
What is the maximum age (older) dog that you want to consider? Please select one.
Please specify if you want a dog for any specific purpose or specialized activity other than companionship, such as:
If other, please specify
Your answer
Would you be interested in adopting a dog with a medical condition?
Would you be interested in adopting a dog with ortho problems?
Would you be interested in adopting a dog with allergies?
Would you be interested in adopting a dog with eye problems?
Would you be interested in adopting a dog with a high activity level?
Would you be interested in adopting a dog with control issues?
Would you be interested in adopting a dog that lacks confidence?
Would you be interested in adopting a dog that barks?
Would you be interested in a dog that is easily distracted?
Would you be interested in adopting a dog that is not compatible with other dogs?
Is there anything else that you want to tell us regarding your application to adopt a dog?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service