Adoption Application
Date: *
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Name *
Your answer
Email *
Your answer
Address *
Your answer
Phone *
Your answer
Occupation *
Your answer
Name of the dog you are interested in
Your answer
Where did you hear about this dog from
Your answer
Do you currently live in *
If other, what do you currently live in?
Your answer
Do you have a fenced yard? *
Your answer
How many adults live in your home? *
Your answer
How many children live in your home? *
Your answer
Ages of children
Your answer
The noise/activity level in my home is usually *
Who will be primarily responsible for the care of this dog? *
Your answer
How much money do you expect to spend per year caring for this dog (vet care, tags, food, supplies, toys)? *
Your answer
On average how many hours will the dog be alone each day? *
Your answer
Where will the dog be kept when no one is at home? *
Your answer
How/Where would you exercise your dog? *
Your answer
Where will the dog be kept at night? *
Your answer
Veterinary practice last used: *
Your answer
Pets currently living in your home
Your answer
YOUR IDEAL DOG
Your answer
What would you do if you could no longer keep this pet? *
Your answer
I certify that the above information is true and correct to the best of my knowledge. I also acknowledge falsification of the above can result in my being denied adoption of an animal or, if an animal has been adopted to me, the return of that animal to The Tiny Pitbull. *
Your answer
Office Use only:
Reviewed by:
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Client Number
Your answer
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