Why are you interested in this particular dog?
We receive many applications for each dog, and may already be in the process of approving
another home for the dog in which you are interested. If this dog is unavailable do
you want us to match you with a suitable companion? YES
Would you consider a special needs dog, one who requires medication? YES
Will you accept a mix? YES
Desired Activity Level: High
Gender Preference: Male
What age range would you like to adopt? Under
1 year 1
yr-3 yrs 3-6
yrs 7 yrs and up
Please list ALL persons living with you or visiting often (age and relationship).
For your peace of mind, you need only list ages of children and need not include their names.
Is everyone in your household in agreement about adopting this dog? YES
Does anyone in the household have any animal allergies? NO
If Yes, to what allergens?
May we visit your home prior to application approval? YES
If yes, when is best?
Please list all the most recent pets you have owned in the past:
Please tell us about your past experience with dogs in general. What
type and size dogs? Include any special
training or activities.
Do you currently have any other pets? YES
What kind? What size? Please describe them, including species, age, gender, personality traits and
Have you ever had to give up a pet? (For example: Sold a pet, given away
or had to give away or take to a shelter)
Please explain why and when.
Will you allow the dog on your furniture? YES
Will you allow the dog on your bed? YES
Please tell us why you want a dog. Describe your "ideal" dog.
Please tell us a little about your lifestyle, your family including any
special activates in which your dog would be included. (If you have any requirements or
requests for a dog, please let us knows so that we can more carefully match a dog to your
If you move, what will you do with your dog?
Do you understand the state and local ordinances concerning licensing and
Have you, or any member of your family or household ever been cited for leash
law violations or cruelty to animals in the past? YES
If yes, please provide details.
When you go on vacation, who will care for your dog and where will it be
What do you like most about having a dog?
What do you like least about having a dog?
Please provide the full name, City State and phone
number (very important) of your current veterinarian:
Who is your local veterinarian?
Vet's Complete Address
Vet Phone Number (including area code)
Vet records are under the name of
Are your pets current on all vaccinations? YES
Where do you purchase heartworm preventative?
Brand of heartworm preventative?
Please identify any other veterinarians that you have used recently? Name
and Phone Number please, including area code.
Do you understand that completion of this application does not guarantee that you will be approved to adopt?
Do you further understand that completion of this form is only the first step in the adoption process and that, should you wish to complete this process, an in-home screening will
Do you understand that Circle Of Hope K9 Rescue requests a donation of an amount agreeable to both parties and that this donation is used to care for other
dogs in our rescue?
As part of the adoption process and before placing any dog, you will be asked to sign a contract in which you agree to certain conditions, such as allowing a
rescue representative to visit your home prior to and after placement of the dog, and surrender the dog back to Rescue if you violate the contract in any
Are you willing to sign and be bound by such a contract?
1/we arrest that the information provided on this application is true and
accurate to the best of my/our knowledge. I/we understand that completion and submission
of this application does not guarantee adoption of a dog. YES
Thank you for taking the time to complete this questionnaire. Circle
of Hope K9 Rescue has only the best interest of the dogs in mind and sincerely wants to adopt
each dog to the family best suited to it. Are there any other comments you'd like for us to consider when reviewing
Clicking the Submit Button will return you to our website.