Dog Adoption Application Form
If a question does not apply to you, please write N/A as the response.
Email address *
About you
Name of animal you are interested in adopting or undecided *
Your answer
Your full name *
Your answer
Phone (Home) *
Your answer
Phone (Work) *
Your answer
Phone (Cell) *
Your answer
Mailing Address *
Your answer
Physical Address, if different from above *
Your answer
Age (must be over 18) *
How many other adults live in your home (state their names)? *
Your answer
What is their relationship to you (roommate, spouse, significant other, etc.)? *
Your answer
How many children are in your home? *
Your answer
What are their ages? *
Your answer
Have they been exposed animals before? *
How often are the children around other animals prior to this adoption, pending success? *
Your answer
Is everyone in the household in agreement to adopting? *
Does anyone in your household/family have allergies/asthma? If yes, please explain *
Your answer
Do children frequently visit your home? *
About Your Home
How long have you lived at your current address? *
Your answer
If less than 2 years, please list former address (over the last 2 years) and reason for moving *
Your answer
What type of home do you live in? *
Do you rent or own your home? *
Note, if you rent, written permission from your landlord allowing adoption will be required.
Are there any restrictions, covenants, or bylaws that limit the number or size of pets you can house where you live? If Yes, what is the limit allowed? *
Your answer
Does your yard have a secure fence (no holes, gaps, or other openings in the fence)? *
How high is your fence (ft)? *
Your answer
What material is your fence made from (wood, chain-link, etc)? *
Your answer
What are the dimensions of your yard? *
Your answer
Current Pets
Do you currently own other pets or livestock? *
If yes, what type of animal(s) (species, breed, gender, age)? *
Your answer
Are your other pets spayed/neutered and up-to-date on their vaccinations? *
If no, please explain why *
Your answer
Dog Experience
Have you previously owned a pet that is no longer with you? *
If yes, explain what type, how long you owned them, and what happened. *
Your answer
Have you ever had to surrender or rehome a pet? *
If yes, explain why: *
Your answer
For what reason would you return/re-home your pet? *
Your answer
Have you taken dog training courses? *
Type of Dog You’re Looking For
If you are applying for a specific dog and that dog is no longer available, would you be interested in being contacted about other dogs who match your criteria? *
Preferred dog size *
Preferred dog age *
Preferred gender *
Preferred coat length *
Describe the activity level you are looking for in a dog *
Your answer
What type of personality are you looking for in a dog? *
Your answer
If applying for a specific dog, what attracted you to this dog? Why are you applying for them? *
Your answer
If applying for a specific dog, where did you hear about this dog? *
Your answer
Ownership
Would you crate/kennel train your new dog? *
Would you feed raw, canned, kibble, or home cooked? *
Your answer
How long will the dog be left alone during the day? *
Your answer
Where will the dog be when left alone (in their crate, loose in the house, in a dog run, in the yard)? *
Your answer
Where will the dog sleep? *
Your answer
How often do you vacation (if at all)? *
Your answer
Where will your dog stay if you go on vacation or out of town for a long period of time? *
Your answer
How often do you plan on exercising your dog? *
Your answer
What forms of exercise will you do with your dog? *
Your answer
Are you aware behavioral issues can arise? *
What sort of steps will you take if the below behavioral issues arise: Chewing shoes/pillows/other delicious but expensive house items, Accidents in the house, Barking and howling when you’re away at work, Aggression towards other dogs, Aggression towards people, Food guarding, Refuses a command, Jumping up. *
Your answer
What sort of training classes (if any) are you planning on, or looking at taking with your dog? *
Your answer
Have you ever returned a dog for any reason, why? *
Your answer
How do you plan to socialize the dog? *
Your answer
Estimate yearly cost for food/vetting/grooming/obedience training/vet emergency *
Your answer
Do you plan to take your pet to the vet for vaccinations? *
If no, why? *
Your answer
Do you plan on purchasing pet health insurance? *
The average life span of a dog is 12-15 years or longer. Are you willing to make a commitment to this pet for the rest of his/her life? *
REFERENCES
Please provide three references, including contact numbers.
Reference 1: Name *
Your answer
Reference 1: Phone Number *
Your answer
Reference 1: Relation to the adopter *
Your answer
Reference 2: Name *
Your answer
Reference 2: Phone Number *
Your answer
Reference 2: Relation to the adopter *
Your answer
Reference 3: Name *
Your answer
Reference 3: Phone Number *
Your answer
Reference 3: Relation to the adopter *
Your answer
How did you hear about our rescue? *
Your answer
A copy of your responses will be emailed to the address you provided.
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