Adoption Application

First Name

Last name

Address

City

State

Zip Code

Email

Phone

Facebook Profile Name

Facebook Link to Profile (i.e. www.facebook.com/jane.dog.8)

Co-Applicant First Name

Co-Applicant Last name

Co-Applicant Email

Co-Applicant Phone

Co-Applicant Facebook Profile Name

Co-Applicant Facebook Link to Profile

Do you have a fenced in yard? If yes, please describe.

Have you ever adopted from a shelter or rescue before? If yes, please list the shelter/rescue's name and when you adopted.

Have you ever surrendered a pet? If yes, please describe.

Do you have a specific dog in mind that you wish to adopt? If yes, please indicate name.

Please describe what kind of dog would be a good fit for your family (i.e. size, age, energy level, etc.)?

Are there any deal breakers that would prevent you from adopting or might lead you to return a dog (i.e. shedding, barking, shy, too much energy, etc.)?

Who will have primary responsibility for the dog?

Where will the dog sleep?

How many hours will the dog be alone on any given day?

What is your plan for exercising and relieving your pet?

Do you plan on restraining your pet with anything other than a leash? If yes, please explain.

How do you plan on disciplining/correcting your pet?

Who will care for your pet when you go out of town?

Are the past and current pets spayed/neutered?

Are the current pets on prevention for heartworm and flea/tick? If yes, indicate whether you obtain from vet or an online company.

If you rent, please provide landlord's name and phone number; we will be contacting to confirm pet policy. If not applicable, put N/A

Personal Reference #1 - List name, phone number and how you know them. Note: one personal reference needs to be a non-relative. This person should be familiar with your pets.

Personal Reference #2 - List name, phone number and how you know them. Note: one personal reference needs to be a non-relative. This person should be familiar with your pets.

Print Full Name (certification that that the above is accurate).

APPLICANT INFORMATION

PET INFORMATION

REFERENCES