Dog Adoption Ready to Adopt a Dog? Don’t fill this out: Applicant's Name Applicant's Occupation Applicant's Age Spouse’s/Partner’s Name (if applicable) Spouse’s/Partner’s Occupation (if applicable) Spouse’s/Partner’s Age Address City State Please select your state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii daho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Mass Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Uttah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Phone # E-Mail Do you or a family member(s) have a relationship with an animal rescue or shelter? If so please explain. Dog being considered Please tell us the name, address and telephone number of your current veterinarian or the one you plan to work with should your adoption application be approved. Please list a personal reference. 1. Do you currently own any animals? Yes No If Yes, please tell us about them. We would like to know their age, gender, breed, size, and general temperament towards other animals. 2. A) Do you have children? Yes No If yes, what are their ages and genders? Do you feel as though they are respectful of animals; are you willing to make sure that your children and your animals respect each other? If no, do you plan on having children? 2. B) Please list any other people (names, ages, gender, occupation of applicable and relation to you) in your household which are not listed under either the children or spouse section. 3. Do you own your own home? Yes No If not, please give us the name and telephone number of the homeowner/land lord. What type of home do you live in? (House, apartment, condominium, etc.) Please describe your home to us: do you have a yard -- if so, is it fenced? Does your family live in an urban, suburban, or rural setting? Most importantly, do you feel as though your situation is the best situation possible for the dog that you are applying for? 4. How many hours a day will the dog be left home alone? When you are not home, where will the dog be (outside in pen, outside in yard, inside free, inside enclosed in an area, or inside in a crate)? Where will your dog sleep at night? 5. What are the driving forces behind your decision to adopt a dog now? 6. Why have you decided on the dog/dogs that you have applied for? 7. If you have previously owned pets, please tell us about them, and their current status (passed on, lost, given away, stolen, etc.). 8. Please do your best to describe the lifestyle of your family. How would this dog fit into your home, what activities do you do or do you plan on doing with your dog/dogs? 9. Do you travel often? If so, what do you plan on doing with your dog while you travel? 10. Who do you believe will be mostly responsible for the care of the dog? 11. Please tell us how much training you have time to put into your dog. Do you plan on taking your dog to puppy classes or obedience? Have you previously trained dogs? Yes No What level of training are you seeking in your new dog or puppy? 12. Will your new dog or puppy be allowed on the furniture or in beds? 13. Where and how will the dog be exercised each day? 14. How do you plan on disciplining your new dog or pup when needed? 15. Do you feel as though you have a thorough understanding of all the myriad expenses that go along with dog ownership? 16. Do you feel as though, regardless of the expense, your dog will always receive the medical care needed throughout his/her life? 17. Are you financially able to feed a higher quality food to the dog adopted? 18. Please describe to us any issues that you feel you would not be willing to work through in an adopted pet. Send