Dog's Name that you would like to adopt:
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Cat's Name that you would like to adopt:
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About you...
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Name:
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Address/City/State/Zip:
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County:
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Home phone number:
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Cell phone #:
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Work phone number:
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E-mail:
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Do you own or rent?
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Own
Rent
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Do you live in an Apartment, House, Duplex or Mobile Park?
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Landlord's name:
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Landlord's phone number:
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How long at current address?
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Do you anticipate moving?
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Yes
No
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How long at prior address?
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Do you have any pets at your residence? (If yes, please list their breed, sex, age and if they have been altered or not.)
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Who is your Veterinarian?
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Vet's phone number:
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Have you had any other pets in the last five year?
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If yes, what happened to them?
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How many children do you have?
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If yes, what are their ages?
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Do any members of your family have allergies to animals?
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Yes
No
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About the dog or cat you want
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Why do you want a dog or cat? (Family companion, hunting, guarding, breeding, other...)
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What attributes are most important to you in a dog or cat?
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Size (small, medium, large, x-tra large):
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Temperament:
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Breed:
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Hair Coat:
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Please tell us the characteristics that you would like in a dog or cat: (Gentle, Friendly, Outgoing, Quiet, Active, Lazy, Athletic, Housebroke, Good with small children, Good with chickens, Good with livestock, Good with other dogs, Cuddly, Independent, Likes water, Good traveler, Protective, Good with cats, Other...)
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Of these characteristics, please tell us the ones that are CRITICAL for you:
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What is your lifestyle (quiet-mostly at home, Average - work but home otherwise, Busy-work and activities away from home often):
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How many hours per day will this dog be without adult care?
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Do you have a fenced yard?
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Yes
No
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If yes, what type of fencing is it and what is the height?
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If no, please tell us how you intend to exercise and potty the dog?
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Where will this pet sleep?
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How much time will this dog spend outdoors?
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How much time will this dog spend indoors?
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If this dog will be outdoors, is there a shelter or dog house available?
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Having a dog or cat in your family is for a lifetime. Are you prepared to make this commitment?
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Yes
No
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Best way/time to contact you:
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Thank you for taking the time to answer our questions. We hope that by going through this process, we will reduce the chance of an inappropriate match both for you and for our animals. If you have any comments regarding this adoption application or our adoption process, please feel free to let us know as we are always looking for ways to improve! Again, thank you for considering a rescue pet and saving a life.
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How did you hear about us?
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