Dog Application Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLast preventative ill you Email *Street AddressCity, State, ZipPhone NumberName of the dog(s) you wish to adoptReference 1Name, Phone, & Relationship to youReference 2Name, Phone, & Relationship to youWhy are you interested in adopting this particular animal?How many adults in the home?How many children in the home?Please list their ageDoes anyone in your home have allergies to animals?YesNoHave you ever had experience with an animal this age?YesNoHow long will the animal be left alone during the day?0-4 hours4-8 hours8-10 hoursMore than 10 hours per dayWill you provide obedience training?YesNoWhere will the animal be kept?IndoorsOutdoorsDo all members of the household agree to adopt this animal?YesNoWhat energy level are you looking for in a dog/puppy?LowMediumHighCurrent petsPlease list how many and what type of pets are currently in your householdDo all your current pets have up-to-date rabies vaccinations?YesNoAre all your current pets up-to-date on vet-recommended vaccinations?YesNoAre all your current pets spayed/neutered?YesNoIf your current pets are not spayed/neutered, please explain whyWhat type of heartworm preventative do you use?N/A if you don’t currently have a dogWhat type of flea and tick preventative do you use?N/A if you don’t currently have a dogWhat type of home do you live in?ApartmentHomeMobile HomeOtherDo you own or rent?OwnRentIf you rent, does your landlord allow pets?YesNoN/ADo you have authorization from your landlord to get a pet?YesNoN/ALandlord Name & ContactPlease provide the name of your landlord and contact informationDo you have a fenced-in yard?YesNoIf you have a fence, how high is it?Less than 4 feet4-5 feet5-6 feet6 feet or higherN/AHow will you exercise your pet?Please describe how you’ll give your new pet enough exercise and bathroom breaksIf you become ill or need to travel, who will take care of your pet?Statement of Understanding (Please check each box if you agree)I have read the posting regarding this animalI agree to provide flea and tick preventative for my new petI agree to provide heartworm preventative for my new petI am financially able to care for this animalI agree to provide adequate shelter and medical care for my new petI agree to provide adequate food/hygeine/companship to the animalI agree to have the animal spayed/neuteredI understand that completing this form does not guarantee that this application will be the one approvedI affirm that everything I have stated is true to the best of my knowledgeSignatureType your full legal name to electronically signDateMM/DD/YYYYSubmit
