Adoption Application "*" indicates required fields EmailThis field is for validation purposes and should be left unchanged.List the dog/dogs you are interested in adopting.*Name* First Last Street Address* Street Name City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State / Province / Region ZIP / Postal Code Phone*Email* Best time to call*Spouse or roommate's name and telephone number*How did you hear about us* Facebook Adopt-a-Pet Adopted Here Before Family/Friends Other Where do you live?*In the CityIn the CountryOn a farmDo you own or rent?* Own Rent Parent/guardian/landlord's name and telephone number (if applicable)*Please tell us about each of your cats and/or dogs over the last five years, including current pets.*Veterinarian's Name*Veterinarian mailing address*Veterinarian phone number*Who will be the primary caretaker for the dog?*How would you rate your dog experience*First-time ownerBeginnerIntermediateAdvancedWhy do you want to adopt a dog?*Family PetGiftGuard DogChild's PetHunting DogOtherIs everyone in the house agreeable to getting a new pet?*YesNoAre you willing to attend obedience classes at your own expense (prices range from $80 to $200)?*YesNoAre there children living in your home? If so, what are their ages?*How many adults reside in the home?*Does anyone in the home have allergies to pets? If yes, who, and how do you plan to deal with this?*Is anyone in the home afraid of dogs?*Where will your new pet spend the majority of his/her time?*Inside HouseInside/outside equallyOutside OnlyWhere will your pet be kept during the day?*Loose inside houseIn a crate inside the houseIn a fence in the backyardIs your yard fenced? How tall, what type of fencing?*Is anyone at home during the day? When?*Where will your new pet be kept at night?*Where will your new pet be kept while you are on vacation, out of town, or away from home for an extended period of days?*How much do you plan to spend on a pet per year?*Are you willing to make a lifetime commitment, which could be 15-18 years for your pet, including medical care, grooming, proper diet, shelter, exercise, companionship, and love?*What problems would make you give this pet up?* Barking Dog's health problems Moving Shedding Digging Illness in family Chewing Aggressive with other dogs Divorce Financial Problems Poor Watchdog New Job Growling at guests Kids are mean to dogs Biting Seperation Anxiety House training issues Allergic to dog New spouse/partner doesn't like Dog not obedient enough Jumping on people Aggressive toward cats New Baby Dog grows too big What would you do if you had to give this pet up?*Give to family or friendPuppy ProtectionTake to nearest shelterSell ItAre you familiar with the use of a crate to train and/or confine a dog in your absence?*YesNoYour ideal dog is (describe)*What traits or behaviors would you have a hard time dealing with in a dog?* Drooling Odor Jumping on people Stubborn Shedding Nervous or shy Aggression Digging Plays too rough with children Dominance Escaping Not good with other pets Biting Submissive Destructive Chewing Too Energetic Noisey Overly Protective Hard to housetrain What traits or behaviors do you most like in a dog?* Independence Dependence Gentle Energetic Confident Playfulness Silliness Quiet Serious Protective Easy Going Some dogs are lively in the house. They like to play with you and follow you around. Do you think an active dog would annoy you?*What is your preferred level of exercise with the dog?* Couch Potato Yard Exercise Short Walks Vigorous Walks Hiking and jogging My new pet should get along with* Dogs Cats Ferrets Birds Farm Animals Young Children Older Children Other Please describe your dog training experience.*What type of discipline will you use when training?*Do all household members understand that it takes time for a pet to adjust to his or her new home?*Select OneYesNoAre you willing to put up with some accidents while the dog adjusts to their new home?*Select OneYesNoWhat kind of solutions would you be willing to try if housebreaking accidents continue after the first week?* Paper training/piddle pads Crate Training Use of dog door Use of dog doorbells Consult a professional trainer None The noise level in my home is best described as:*Select OneLowMediumHighWill your new pet be allowed on the furniture?*Select OneYesNoHave you ever had behavior problems with previous dog(s)? What did you do to correct the issue?*What made you decide to adopt this particular dog?*In the last 6 months, has a dog or puppy died on your premises of distemper, parvo, or unknown causes?*Select OneYesNoWould you object to our visiting your home prior to the adoption or as a follow-up visit?*YesNoWould you object to our verifying any of the information provided on your application?*YesNoReferences (need 3 to be considered): non-relativeReferences 1Name*Phone*References 2Name*Phone*References 3Name*Phone*
