Dog Adoption Application Your Name Street Address City State Zip Phone Number Email address Why are you interested in adopting a dog? If there is a specific dog you're interested in adopting, please enter the name: Current Pets How many pets do you own? Please tell us about your current pets Type/Breed Name Age Sex Male Female This pet has been spayed/neutered Where is this pet primary kept? Inside Outside Both Where did you get this pet? How long have you had this pet? Have more pets? Click here for additional space You & Your Household What is your experience level with dogs? First Time Guardian Have had one or two Knowledgeable and Experienced On average, how much time do you spend away from home? Home all day Out part-time Gone 7-10 hours at a time Our dog will live: Indoors only Indoors/outdoors Outdoors only In a garage/basement How would you describe the atmosphere around your home? Grand central station Some activity Calm and Zen-garden serene Do you have a fenced-in yard? Yes No If so, how tall is it? Your Ideal Dog What is your ideal breed type/mix? Preferences: Adult Size 0-20 pounds (Small) 20-50 pounds (Medium) 50-100 pounds (Large) Over 100 pounds (Giant) Age 8-16 weeks 4-12 months 1-3 years Older No preference Exercise Requirement Low Medium High Sex Male Female No preference There are allergies in the household What is your housing situation? Own a home Own a condo Rent a house Rent an apartment Live with relatives If you rent, please provide your landlord's name and telephone number: Names of others in the household (include ages of children): Who is your veterinarian? Pets you have owned in the past five (5) years Type/Breed Age Sex Male Female Spayed/Neutered What happened to the pet? Had more pets in the past 5 years? Click here for additional space Is there anything else you would like to add about your family? By submitting this form I certify that all the information on this application is true and I understand that false information may void the adoption and future adoptions from this organization. Further, I understand that the completion of this application does not guarantee an adoption. Submit Thanks for your application! One of our elves will be contacting you soon
