Your Full Name
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Your E-mail Address
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Your Phone Number
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Address
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City
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County
State
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- - Choose One - -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
D.C.
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
*
Your Date of Birth (note you must be 21 years of age and ID must be provided if approved for adoption)
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Employer and Occupation
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What is the name of your veterinarian? They will be contacted for reference
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What is your veterinarian's phone number?
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I give permission to call my vet for reference
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Yes
No
Please provide 3 unrelated, personal references. Include name and phone number.
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What Sex Are you Looking For?
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Female
Male
Doesn't Matter
Is there a certain dog you're interested in?
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Where is this dog located? City and state?
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Who is the DDB volunteer representing this dog?
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Is your yard fenced in?
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Yes
No
If not, how do you plan to keep your dog safe when outside?
Do you have children who live with you? If so, what are their ages?
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Do you have other pets? If so, list names, breeds, ages
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Are all of your pets spayed/neutered? If not, why not?
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Does everyone in the family want this pet? If not, why not?
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Will the pet be left alone for extended periods of time? If so, where will he/she stay?
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Do you own or rent?
Own
Rent
if you rent, what is your landlord's phone number?
Have you ever given up a dog? If so, why?
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What kind of temperament are you looking for in a dog?
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Are you willing to consult/hire a trainer/behaviorist if needed to help with issues if they arise?
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Yes
No
Not sure
What kind of activities are you planning with your dog?
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Show us your environment/Upload pics of your pets, home and yard
More pics
More pics
Do you understand that this is a legally binding contract but does not guarantee application approval? A final contract will be signed by both parties upon the completion of the adoption.
*
Yes
No
Security Code
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