Adoption Application
• Must be 21 years or older with identification showing present address.
• Must have the knowledge and consent of all adults living in the household.
• Renters must show proof of pet deposit and lease allowing pets if renting.
• Must be able and willing to spend the time and money necessary to provide training, medical treatment and responsible care for a pet.
Applicant Name: *
Full Address: *
Name of Dog you are interested in adopting *
Best contact Phone: *
Alt Phone:
Email: *
DOB: *
Number of children in household? *
Number of adults in household? *
Number of dogs living in your home: *
Number of cats living in your home: *
M/F and number of each?
Approximate weight of each?
Are any of your pets unsterilized? *
If so, explain:
Are all dogs current on their shots? *
Are all dogs on heartworm preventative? *
Are all dogs on flea/tick prevention medication? *
Have any of your current pets had medical problems in last 12 months?
Description of medical problem(s):
Any behavioral problems with your current pets?
How are the problems being addressed?
Would you seek help from a trainer if the pet you want to adopt develops a behavioral problem?
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