ADOPTION APPLICATION 

Please answer all questions  completely! If there are any blanks, we cannot process the application and it will be discarded. Your driver's license numbers are used for the criminal background check.

Date:                            Name of dog you are interested in:

Full names of all adults in the home (include middle names):

Adult #1:                                                                        
Date of birth:
Occupation:
Employer:
Driver’s License #:

Adult #2:                                                                        
Date of birth:
Occupation:
Employer:
Driver’s License #:

Adult #3:                                                                        
Date of birth:
Occupation:
Employer:
Driver’s License #:

Adult #4:                                                                        
Date of birth:
Occupation:
Employer:
Driver’s License #:

Physical address:

Mailing address:

Phone Number: (H):                                     (W):                                   (C):
E-mail address:

Do you live in a house?                Apartment?                Townhome?

Do you own your home?               Rent?

If renting, does your landlord allow pets?                   This breed?                                  

Can you provide this permission in writing?

Landlord’s name:                                                     Phone number:

Do you have a fenced yard?                       If yes, how tall is it?           What kind of fence?

Will the dog be chained in the yard?

What brand of dog food will you be feeding?

Are you looking for an inside or outside dog?

Where will the dog sleep at night?

Where will the dog be when no one is at home?

If you have other dogs, do you plan on separating them while you are gone from the home?

If so, then how will you separate them?

Where will the dog be when you are gone overnight?

How many hours per day will the dog be left alone?

Are their children in the home?                    If so, what are their ages?

Do you have other pets?                                If so, what kind?    

Names and ages of all pets:                  

Are they spayed and/or neutered?                  If not, why?

Will the dog travel in the back of a pickup truck?

Have you ever given up a dog before?          If so, please state the reason:

Have you ever been required to relinquish any of your animals?

If yes, what were the circumstances?

What circumstances, in your mind, justify giving up your dog?

What would you do with the dog if the above circumstances occurred?

What will you do with the dog if you move?

Are you willing to housetrain a dog?

Has anyone in your immediate family/household ever been charged with: 

Cruelty to animals?
Child abuse?
Domestic violence?

If yes, please explain the circumstances and disposition of charge:

Have you ever had this breed before?                   If not, what made you choose this breed?

Are you familiar with the characteristics and temperament of this breed?

Name all the breeds of dogs you have had in the past:

What kinds of activities do you anticipate enjoying with your dog?

Name and address of your Vet:                                             Phone number:

If you do not have a vet now because you have no animals, please give the name and phone number of your previous vet:

Please notify your vet that we will be calling and give permission for him/her to speak to us

Please give at least 3 references with phone numbers:

1.

2.

3.

What are the characteristics you are looking for in a dog?

Additional comments: