Age Applicant 1
Applicant 2 First Name
Applicant 2 Last Name
Age Applicant 2
Please list ALL of the members of your household, whether they are relatives or not (name, age, relationship):
Number of Children
What breeds of dogs have your children lived with?
How long have you lived this address?
Which best describes your current home? (select all that apply)
Please provide the name and phone number of your landlord (renters, parents) or land owner (mobile home).
Is everyone in your household in agreement on adopting a pet?
Does your home have a yard?
Is your yard completely fenced? Is fence secure underground? Is gate padlocked?
Why do you want to bring a new pet into your home?
Where will your pet be kept when nobody is home?
What breed of dog are you applying for?
Do you prefer a male or female dog?
What age range?
Is there a particular pet on our web site that you are interested in adopting? If so, which one(s)?
What activities do you plan to do with your adopted dog?
Will this dog be used as a guard dog?
Have you ever owned a rottweiler or a pitbull? Where is that dog now?
Under what circumstances would you give up your dog?
Do you have any pets currently? List type, breed, age & gender
Tell us about the pets you have owned over the last ten years. i.e. species, how many years owned, reason for no longer owning them.
Have any pet of yours ever gotten lost? Poisoned? Killed by a vehicle? If yes, please provide explanation.
Veterinarian's Name & Phone Number. Please also tell us what name the pet is under at the vet's office.
Are your pets current on vaccinations?
Are your pets spayed/neutered?
Are your pets on heartworm preventative? What brand?
When did you visit your veterinarian last?
Completion of an 8 week level one obedience course is mandatory at adoption. Please do not complete the application process if you are not willing to attend training classes for socialization and bonding with your new dog. We can recommend many very good trainers in our area. Please as for a list if you need a referral.
Which trainer do you plan to use with your adopted dog?
All of the dogs placed have undergone thorough temperament evaluations and have lived with foster families prior to their adoption.While in foster care, we begin training and work to resolve any behavioral obstacles before adoption. Generally we are only able to give you the dog's history from the time it enters our program. Are you able and willing to continue working on these challenges with us to ensure that your adopted dog is a respectable canine companion and family member? Your comments are encouraged.
Please provide the name and contact information of two persons who have been to your home and are able to discuss your interactions with your pets.
Reference #1 (name, relationship, evening phone number, email address):
Reference #2 (name, relationship, evening phone number, email address):
I certify that the information I have provided on this form is true, correct, and accurate. I am financially and physically able to care for the animal that I adopt. I understand and agree that falsification of any of the above information is grounds to disqualify my adoption application and nullify all adoption(s) and/or adoption agreement . I understand that there is no obligation to adopt an animal to me, now or in the future. I understand that my electronically-generated signature [below] is valid as a means of legal signature for the purpose of this adoption application (Yes or No)