First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone*

How did you hear about Dog Gone Seattle?*

Which dog are you interested in adopting?
Choose an animal: * Betty - PENDING * Opal - Adoption Pending Aiko Ames April Artemis Ashley Athena Atlas Bingo Birdie Blossom Brad Bradley Brick Brie Buddy Buffalo Buttercup Carrot Casper Champ Charlotte Chopper Coco Cody Congee Copper Darla Diesel Dodger Dusty Ears AKA Simon Eddie Ears Elsa Felix Feta Finley Freya Goose Gully Gunner Gus Hap Harold Harper Jazzy Jerry Jinju Jules June Junior Kelly Kendall Kimber King Kylie Liv Lizzie Lucy Luna Maestro Mama Millie Marge Marlo - HOLD Millie Nala Nellie Nutmeg Olivia Otter Paisley Pebbles Penny Petra Poe Praline Quiz Raven Ria Rocco Romi Ronnie Rose Ryder Sadie Sally Sprout Starla Sundae Sysco Talia Tessa Tink Tootsie Verina Wallen Wrennley Zeus the Puppy Zeus the Staffy Zola

Please briefly describe why this dog caught your attention (e.g. look, temperament, breed, potential for specific activity, personality). If you are interested in multiple dogs you can write their names here.*

What are your primary reason(s) for wanting to adopt a dog. Check all that apply.

After a meet and greet, if approved for adoption we expect adopters to be able to finalize the adoption and welcome the dog home within 72 hours. Do you have any upcoming obligations (travel, financial, etc.) that will affect your timeline for being able to adopt a dog?*

If yes, please explain

Would you be willing to allow us to visit your home prior to adoption?*

Please list all household members, including age and gender*

Are you expecting a child in the near future?*

Is anyone in your household allergic to dogs?*

If yes, please explain

Please select your dwelling type:*

Do you own or rent your home*
Choose one: Rent Own

If you rent, does your building allow dogs?

If applicable, what are your pet restrictions (breed/weight)? Please be specific

If you rent, please provide name and phone number of your landlord / rental manager.

Does your dwelling have a private yard?*

If yes, is it securely fenced?

If yes, what kind and how tall?

Please list all dogs currently in the home. Include age, breed, sex, and special notes if applicable *

Please list all cats currently in the home. Include age, sex, and special notes if applicable*

Are all dogs and cats in your home currently altered (spayed/neutered)?*

If not, why?

Are all dogs/cats in your home currently up-to-date on core vaccinations including (for dogs) Rabies, DAPPv and Bordetella?*

If not, why?

Aside from the dog(s) and cat(s) referenced above are there any other animals in your household? Please explain.*

Please list past dogs you have previously owned, including breed, cause of death, and any special notes about that dog (i.e. childhood pet, separation anxiety, etc).*

Have you previously worked with a dog trainer or attended obedience training classes?*

If yes, which trainers or programs? If no, why?*

Which if any of the following have you used in the past? Please check all that apply

Have you ever had to give up a pet?*

If yes, why?

For what reason(s) would you return a dog to us?

What activities do you plan on participating in with your dog?*

How do you plan to ensure that your dog receives safe and adequate exercise?*

How many consecutive hours are you or someone in your family typically away from home during the day?*

Do you plan to use a crate while you are gone?*

What is your plan for the dog during the day? Please explain.*

Where will the dog sleep?*

Where do you plan to keep the dog primarily?*

When you are traveling, where will the dog stay?*

What kind of behaviors do you expect from this dog?*

Please indicate issues you are confident in handling:

For any issues left unchecked, please indicate what you would do should you encounter those behaviors.

What amount of time can you dedicate a week to training the dog?*

Are you planning to enroll your dog in obedience training?*

If yes, do you have a trainer in mind?*

If no, would you like a recommendation for a trainer?*

Please describe your training plans -- Which family members will assist in training? What are your training objectives? What is your definition of discipline? How would you stop unwanted behaviors?*

Please let us know anything else that would make you an ideal candidate to adopt a rescue dog?*

Please include the name, phone number, email address and relationship of at least two people who can attest to your suitability as a pet owner. *

Please provide the name and phone number of your current veterinarian. If you do not have a current vet, please indicate the vet you plan to use.*

Would you like to receive email notifications and updates from Dog Gone Seattle?

I certify by my digital signature below that the information entered on this application is true.*