ADOPTION APPLICATION FORM

Name	*
Address	*
City	*
State	*
Zip code
Cell phone
Home phone
Email address
Age
Occupation
Spouse/partner Name
Spouse/partner email
Spouse/partner cell phone
Spouse/partner age
Spouse/partner occupation
If other adults in home, list names & ages:
If children in home, list names & ages:
Type of home live in(ex: single family home, condo/apartment, etc)	*
Do you own or rent you residence?
If renting please provide landlord name & phone number
Is your yard fully fenced? If so is it regular or invisible/electronic type?
Do you currently have cats? If so list names, ages & if spayed/neutered
If have current dog(s), what is dog #1 name, age & breed:
If have current dog(s), what is dog #1 weight, sex?
If have current dog(s), is dog #1 spayed or neutered?
If have additional dogs list names, breeds, sex, age & if spayed or neutered:
Additional current pets list here:
How many dogs have you owned in last 3 years?
What breed(s) of dog are you applying for?
Have you ever had this breed before? If not why are you considering this breed?	*
What age are you looking for (ex: under 1, 1-4, 5 or over)?
Are you looking for male, female or doesn’t matter?
How many hours will dog be alone per day?
Where will dog spend most of the day?
Where will dog sleep at night?
Are you willing to attend obedience training?
How will you exercise your new dog, please explain?	*
How far each way are you willing to drive to pickup your new dog? (We don’t meet part way or deliver/ship dogs)
What reasons in your mind justify getting rid of a dog? Please be specific:	*
Current Veterinarian Information (list vet name & phone number):
Additional info or comments:
I understand the adoption donation fee is not refundable.	*	Yes