Belly Up For Adoptions - Adoption Application
We need some important information to start your adoption journey and ensure we always make the best match beweeen home and canine!
Name *
Your answer
Address *
Your answer
Preferred method of contact *
Cell #
Your answer
Home #
Your answer
E-mail *
Your answer
Permission to perform background check *
A background check helps us verify eligibility of adoptive parents. You may say no now and it can be discussed further later.
Date of birth *
Current employment *
Your answer
What dog are you interested in? *
Your answer
Tell us why you want a dog *
Your answer
How many years at your current address *
1 month to
(or longer)
In the last 5 years, how many times have you moved? *
Do you have a yard? *
Size of yard
Your answer
Is the yard enclosed?
Own or Rent? *
Describe your current home *
If condo or apt are pets allowed?
If renting or condo - landlord / management company / association contact info to verify pet policy
Your answer
How many adults are in the house? *
Any pet allergies in your household? *
Describe any pet allergies in the household
Your answer
Number of Children *
Please describe your children
Your answer
Does everyone in household share the desire to get a dog? *
Your answer
Do you have any other dogs? *
Please describe your other dogs including: their age, breed, how long you have had them.
Your answer
Are your other dogs neutered?
Your answer
How many hours will your new dog be alone per day *
Where will your dog be when you're not home? *
Your answer
How will you exercise your dog? *
Your answer
Will you go through training classes with your new dog? *
Where will your dog go when you take a family vacation? *
Your answer
What might make you return a dog? Select any that apply
Have you ever given a pet away or relinquished a pet to a shelter? *
Explain any times you have surrendered a pet in the past
Your answer
What will you do with your dog if you move? *
If you are unsure please enter discuss and we can help you explore the options
Your answer
What provisions will you make for your dog if you become unable to care for them? *
If you are unsure please enter discuss and we can help you explore the options
Your answer
What will you do if your new dog/puppy develops problem behaviors? i.e. barking, digging, chewing, jumping, pottying in the house...
Your answer
What will you do if your new dog develops any aggressive behavior?
Note: We want you to think of every possibility, no matter how small.
Your answer
How do you plan on house training your new dog?
Your answer
If you do not know how to train your new dog or deal with any problems, let us know how we can help
Your answer
Vet Care
Do you already have a vet? *
If yes please provide Vets name and address
Your answer
If yes provide Vets phone #
Your answer
Can we contact current Vet about this and any other past pet of yours?
Any information will be treated in confidence unless required by law
Owning a dog means paying for food, toys, treats, vet care, immunizations, and more. Are you ready to pay for these things for the dog’s entire life? *
Please explain any other reason why you might return a dog?
Your answer
Tell us anything you think might help!
Your answer
Your satisfaction with the wording and options on this form?
Please help us by rating this form from 1 to 10. 1 being unhappy, 10 being very happy.
Things to think about
What will you do when you come home and find the dog ate your real expensive/favorite leather shoes?

What if you your dog pees on your carpet? on your bed spread/comforter?

What will you do when your dog cries all night the first few nights in the new home?

What happens when your dog chews the legs on your dining room table?

What happens if your dog tears his/her ACL while playing in the yard and it will cost you $2000 to have it repaired?

Thank you so much!
Thank you for taking the time to provide all this information. It is incredibly valuable to us in helping you find a great dog to bring into your life! This response will be kept and viewed securely over https:. Information will only be used in your application to adopt a dog from Belly Up For Adoptions.
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