Application to Adopt or Foster
THANK - YOU for your interest in our dogs. We would appreciate your answers to the following questions, so that we can best select the right dog for you. All applicants must have a fenced yard. All information is treated as confidential. Submission of this application does not guarantee that you will receive a dog.
INCOMPLETE APPLICATION IS REASON FOR REFUSAL!! PLEASE PRINT!!
Name: ___________________________________Spouse:_______________Date:_______________
Address: __________________________________________________________________________
City: ______________________ County: _________________ State: _________Zip:______________
Home Cell Work
Phone: _____________________ Number:____________________Phone:______________________
Email Email
Address____________________________________#2_____________________________________
Place of Employment_______________________ Place of Employment________________________
Job Title __________________________________Job Title: ________________________________
Drivers Date
License:_______VERIFIED UPON ADOPTION, you do not need to list the #of Birth____________
Name & Phone # of
your Veterinarian(s):_________________________________________________________________
Describe the dog you
Want including breed: ________________________________________________________________
Are members of the family home during the day? _________Who:_____________________________
How long would the dog be left alone during your work day or night? ___________________________
List all people living in house
Include age and relationship: __________________________________________________________
__________________________________________________________________________________
Do you live in house, apt., trailer, condo, other, describe: ____________________________________
Do you own, rent or other describe? ____________Does your rental agreement permit pets? _______
Landlord__________________________________Phone#____________________________
How long have If less than 5 years
you lived there?_________ Previous Address:____________________________________________
Is property
Fenced now? ____________ What type of Fence and height? ________________________________
Size of Does fenced area attach or surround
Fenced area__________________________ building where the dog will be housed? ______________
How many hours will the dog be outside a day? _____________
Where will the dog be kept during the day?
(Dog house, shed, barn, kitchen, crate, etc).____________________ Night: ____________________
When you are not home where will the dog will spend it’s time? House, Yard, Garage, Crate _________________________________________________________________________________
Can you afford medically to treat an ill dog if necessary? ____________
Do you know how much does it costs per year to own a dog? How much? _______________________
Why do you want a dog? ____________________________Is the dog a gift?____________________
Have you ever owned this breed? ____________What happened to it? _________________________
Where did you get it? ________________________________________________________________ How long since you’ve owned a dog? ________________________________________
Do you plan on any type of training? If so what type? ________________________________________
Do you know what a puppy mill is? _____________ Have you had any experience with special need dogs? ______________________
Have you placed, lost or euthanized
any dogs in the past, explain________________________________________________________
Do you have any Pets? If so list all
NAME, AGE, BREED & SEX:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________
Are your pets current on vaccinations? Rabies _________DHLPP _________Heartworm___________
Are your pets SPAYED/NEUTERED? _________If not Why? _________________________________
Please give
Are your dogs licensed? ________ license Numbers: _______________________________________
What kind of Canit comfortably
Vehicle do you drive? _______________________ hold a dog?__________________________
List 3 Personal references with Phone numbers (NO RELATIVES OR WORK NUMBERS)
1) _______________________________________________________________________________
2) _______________________________________________________________________________
3) _______________________________________________________________________________
Have you ever applied to adopt from a Rescue
or Humane Society to adopt a dog or cat before? __________Results? ___________________
What orginization? _______________________Phone#_______________________________
If interested in Fostering, what type of fostering interests you most??
Long term_______________Shortterm_________________Special needs____________________
Your signature or electronic signature authorizes us to contact your references and verify all information provided to us on this application. Signature:_________________________________________________