Adoption Application


Your name:
Phone number:
Cell number:
Email address:
Street address:
City:
State:
Zip code:


Age:
Occupation:
Drivers license number:
Work address:
Work city:
Work state:
Work zip code:
Work phone number:


Name of dog interested in:
Number of adults in household:
Number of children:
If you have kids, please indicate
how many and their ages:
Vet name and address:
Vet phone number:


Have you used this vet in the past for
previously-owned or presently-owned pets?:

(please explain)                     

Do you own or rent:
Landlord name and phone number if renting:
Who will be the primary caregiver(s) of this dog:


Do you have any pets at the moment:
If yes, please list each animal type, sex and age:
If no, what happened to
the pets you no longer have:
Where will dog be kept during the day:
Where will dog be kept at night:


Do the pets you own now or have
previously owned been spayed or neutered?:
If no explain why:


Do you have a fenced in yard:

What means will you use to allow the dog to do
his business? (ex: fenced in yard, leash walking, tether or
line attached to home, overhead run, kennel area, etc.):

How many hours a day, on average, will the dog be left
by itself? (while you are at work, out running errands, etc.):

What is your feeling on crating and/or crate training?:

Vet care and maintenance of a dog runs an average of
$500 a year. Are you financially prepared for this? And are
you willing to consider a reasonably cost pet insurance?:

What means of flea and tick prevention do you plan to use?:

If you are ever unable to care for your
dog in the future, what would you then do?:

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