COPY & PASTE THE BELOW INTO AN EMAIL TO US: email@example.com
first step in the adoption process is sending in a completed adoption
application. Please fill out & return the below adoption application &
once approved, we'll gladly arrange a visit for you!
* We run background checks, so kindly provide your FULL NAME, not
nickname or abbreviated name*
Before you fill out this application make
sure that you have considered all the responsibility involved with taking in an
animal to your family. This is a lifetime commitment and should be thought
through carefully. Companion pet ownership means financial obligations for
regular maintenance and an illness or injury can occur during the pet’s
lifetime. The information included in this application must be accurate and the
applicant must be at least 21 years of age. If any information is found to be
false it will result in our not approving your application and not allowing
adoption in the future.
*If less than 5 years, previous address
Facebook page under what name/email
Employer Phone #:
*Required* (for background check)
*Your application will not be processed without this
information. Your driver's license will also be required at time of
How did you hear about us?
Who would you like to
**Please list at least 2 dogs**
Live with parents:
How long have you lived at your current address?
plans to move in the near future?
The following must be completed so that
we may verify that you are allowed to own pets:
If you rent, are you
Does your rental agreement restrict the type of pet you may
own by size or breed?
Please list all people living in your
in your home have allergies to any animals?
If yes, what specific
allergies and to what animals?
Are all members of your household in
agreement of adopting a dog?
For whom are you adopting this
Who will be the primary caregiver of this animal?
be financially responsible for this animal?
Why do you want this
Please list all animals owned over the last ten years beginning with
animals currently living in your household.
Alive or Deceased?
If deceased, when?
Vet you used for this pet(s):
*How were these pets acquired? (Adopted, purchased, gift)
pets current on their vaccinations?
Does your pet get along with other
How many dogs have you owned in the past?
Have you ever
taken a pet to the shelter?
Have you ever had a pet lost or
Have you ever had to retrieve your pet from a
Have you ever had a pet get hit by a car?
Do you have a
Is it fenced?
If YES, how high is the fence?
If NO, how will
the dog be exercised and go to the bathroom?
Do you have a
If YES, is it enclosed?
What is your level of
How many hours are you gone from your home per
Do you travel?
Who will care for your pet when you
Do all adults work full time?
How many hours a day will
your dog be alone?
Do you have a pool?
Are there stairs leading
into your home or inside your home?
Where will your new dog be kept when
Where will your new dog sleep at night?
Do you object to a
Can you financially afford to provide Veterinary care for
your dog? (care per year can be $300 to $500 or more yearly)
If and when
you need to move, are you willing to take your pet with you and if necessary
provide extra security deposit to be able to take your dog with you?
you become ill, who will take care of your pet?
Personal Reference 1: (must be non-family
Reference 2: (must be non family member)
Do you have a veterinarian?
Do we have
permission to contact your veterinarian?
Veterinarian records are under what
Please tell us a little about you (and your family, if applicable)
**THIS AREA CANNOT BE LEFT BLANK**
By signing this
application I certify that the information provided in this form is true and
accurate to the best of my knowledge. I am aware that the completion of this
application does not guarantee the approval to adopt a dog from our rescue. I
give the rescue permission to contact my Veterinarian permission to release all
information on my current and previous pets to the rescue. In signing I am also
giving permission to call my references and landlord. I understand that this is
the first step in the adoption process and that if this application is approved
that I will fill out an adoption contract and make a donation in order to
finalize this process. (we accept checks and cash) This application remains the
property of the rescue.