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Adoption Application

Please fill out this application completely, hit submit and then done.

Desired Dog/Cat
Applicant's First Name
Applicant's Last Name
Applicant's Age
Co-Applicant's First Name
Co-Applicant's Last Name
Co-Applicant's Age
Address
City
State
Zip Code
Email Address
Home Phone
Alternate Phone
Best Time to Call
Have you applied to any other rescues for a dog at this time?
Why do you want to adopt this dog?
First name of Household Member # 1 other than Applicant and Co-Applicant
Age
Relationship
First name of Household Member # 2 other than Applicant and Co-Applicant
Age
Relationship
First name of Household Member # 3 other than Applicant and Co-Applicant
Age
Relationship
Do Children visit your home?
If yes, ages and frequency
Who will be the main caretaker of this dog?
Type of home?
Do you own or rent?
If rent, Landlord's Name
If rent, Landlord's Phone
***Please note: We require you provide a letter to us from your landlord or a copy of your lease stating that pets are acceptable. Please acknowledge this by selecting YES
If rent, length of time remaining on lease?
How long do you expect to be at your current residence?
Do you have a fenced yard?
If yes, explain height and type
How will the dog be exercised, how often, and who will supervise the dog while outdoors?
Do you have a swimming pool?
Where will the dog be kept during the day when left alone?
Where will the dog sleep at night?
Do you have a problem crating a dog when you are not around?
How many hours a day will the dog be left alone?
Do You Currently have any pets in the household?
If so please list info below for each pet
Type/Breed Pet 1
Age
Gender
Spayed/Neutered
Type/Breed Pet 2
Age
Gender
Spayed/Neutered
Type/Breed Pet 3
Age
Gender
Spayed/Neutered
Veterinarian Name
Veterinarian Address
City
State
Zip Code
Veterinarian Phone
Additional Information you want to provide?
  

By submitting this application I agree that I have reviewed my application carefully and have answered these questions to the best of my ability.

Please note that you must be at least 18 years old to fill out this adoption application. A reference check will be done and a home visit before any adoption is finalized.

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