Adoption Application Please enable JavaScript in your browser to complete this form.Name *Email *Phone Number *Address *City *State *ZIP *Do you rent or own your home? *RentOwnLive with parents/guardianOtherDo you live in a *HouseApartment/CondoRanch/FarmOtherDo you have a fenced in yard? If yes, what kind of fence, wood, chain link, invisible, etc. *Do you have a pool?YesNoLandlord/Management company name and phone number (if applicable):How long at current address: *What is your home environment like: *Very ActiveSome activityRelaxedHow many adults live in your home (including you)? *1234 or moreHow many children live in your home? *0123 or moreWhat are the ages of the children?Are there children that visit your home? *YesNoIf yes, how often and what are their ages?Does anyone in your household have animal allergies? *YesNoWhere do you work? *Is there a specific breed and/or size of dog that you want to adopt? If so, please specify. *Is there a specific dog that you are interested in adopting? Who? *What experience do you have with dog behavior and how would you work through any behavior issues your new dog may have? *Have you had any experience taking care of a dog with medical issues? If yes, please explain. *Are there any lifestyle altering events that could occur in your future? (ie. new baby, moving, caring for elder, divorce, job uncertainty, health). If so, please explain. *References:Name and Phone Number of Veterinarian *Groomer's Name and Contact Info, if applicablePersonal Reference #1 Name and Contact Info (no family members): *Personal Reference #2 Name and Contact Info (no family members): *Have you ever surrendered an animal to a shelter or rescue or individual? If yes, please explain the circumstances. *Where will the dog be kept? *IndoorsOutdoorsBothTell us about your current or recent pets:What Heartworm Preventative and Flea Preventative do/did you give your pets? *Animal #1: Name and AgeBreedSexFemaleFemale, spayedMaleMale, neuteredIf you no longer have this pet, what happened?Animal #2: Name and AgeBreed SexFemaleFemale, spayedMaleMale, neuteredIf you no longer have this pet, what happened? Animal #3: Name and AgeBreed SexFemaleFemale, spayedMaleMale, neuteredIf you no longer have this pet, what happened?I certify that the above information is true and correct, and understand that providing false information may result in nullifying this application. *Yes, I agreeCommentSubmit
