Adoption Application

Name of adoptable dog or what you are looking for *

Full Name (First, Last) *

Address

Address Line 1

City

State

Zip Code

Phone *

Email *

People's Names and Ages in Household *

Have you or anyone in your household been convicted of *

An Animal Abuse Offense?
A Felony?
A Drug Offense?
No

If yes to any, please explain in detail

Own or Rent (Please list landlords name and phone #) *

Personal references with name and phone # (Please list 2 people who personally know you and how you are with your animals- Not family or living in the same household)

Complete Veterinary Information for Current and Past/Deceased pets (Please list Vets Name, Address and Phone #)

Current and Deceased pets (List Name, Breed, Age, Spayed/Neutered, Up To Date Vaccines. If they are Current or Deceased)

Have you ever rehomed a dog? If so please explain situation in detail

Do you have a plan in place for your dog(s) if something happens to you? If so, please let us know what that is.

Where do your dogs spend their time in your home? LIVE? SLEEP?

How many hours a day are/will dog(s) be left home alone?

If you have a fence what type do you have? What part of the house does the fence surround? If no fence how do your dogs get their exercise?

Do you agree to a home check prior to adoption?