Dog/Puppy Adoption Application

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Name (First and Last) *

Street Address *

City, State, Zip Code *

Phone Number *

Email Address *

Will any children live with this animal and what are their ages? *

Which animal are you interested in adopting? *

Will this animal be a gift for someone else? *

Yes

Do you rent or own your home? *

Rent

Own

If renting, do you have permission to have this pet? *

Yes

N/A

If renting, do you give us permission to contact your landlord? *

Yes

N/A

Describe your fence *

chain link fence

wooden privacy fence

I do not have a fenced in yard

Please tell us about the pets you currently have in your home and whether they are spayed/neutered and any vaccinations they have had. *

If you currently have dogs are they on heart worm preventative and if so, what are they on? *

Please tell us about the pets you do not currently have but have had in the last five years. Why do you no longer have them? *

Do you work outside the home? *

Yes

How many hours per day are you and other family members away from home? *

Where will this animal spend the majority of the time during the day? *

Inside

Outside

Inside with access to a doggy door

Other:

Where will this animal spend the night? *

Please tell us how your current pets respond to new pets in the home? *

What will you do if your current pets and this animal do not get along? *

Name, address and phone number for your current veterinarian *

Do you agree to allow CAPA to contact your veterinarian? *

Yes

N/A

Do you agree to allow CAPA to do a home visit prior to adoption? *

Yes

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