Name: Age: Spouse Name: Spouse Age: Home Phone: Cell Phone: Address: City: State: Zip: Work Phone: How long have you lived at this address?: Occupation: Employer: Time With Employer: Spouse Occupation: Spouse's Employer: E-Mail: Name & number of animal you are interested in: Why this particular animal?: How long have you been looking for a new pet?: Do you live in an: Apartment townhouse/condo private home Do you: own / rent? Do you have a fenced in yard?: Yes / No? Completely Fenced?: Yes / No? If renting does your landlord allow pets?: Yes / No Name and phone number of Landlord: Household make up: Number of adults
Number of children , ages of children:
Do any children visit you? yes / no Describe pets residing with you, ie. type, age, animal name and if spayed / neutered : Who will be responsible for caring for this pet?: Where will your pet spend a most of it's time?: How many hours will it be left alone?: How do you feel about crate training?: Have you owned a dog before? If so what kind? Please provide names and years you had them. What happened to them? Please provide details: Name and phone number of your current veterinarian? If you do not currently have a vet, please list any past vets with name of pet and year you used them.: When were you last there, and the name of the animal seen?: Who's name is the animal under: How often should a dog see a veterinarian?: How much and how often should you feed a dog?: Describe your lifestyle, i.e. Active, Relaxed?: What do you like to do in your spare time?: Why do you want a dog?: If applicable; What are your children's hobbies and/or play habits?: Do you frequently entertain, or get many visitors?: yes / no Do you have rules for your household?: yes / no
If so, briefly describe them:
We require animals to be spayed/neutered, do you have any questions or reservations about this policy?: yes / no
If so, describe:
Name, phone number and relationship of 2 personal references? Not relatives: How did you hear about our organization?: Since most animals have unknown medical backgrounds, are you prepared to take your new pet for a complete veterinary exam within 2 days of adoption, and to provide any necessary medical treatment at your own expense?yes / no
The purpose of this application is to place the pet in what we feel is the best suitable home.
We reserve the right to refuse any adoption.
You should be contacted within 24-48 Hours.