Apply for a pet

Name of animal you want to adopt

Today's Date

Name

Email Address

Your Age

County of Residence

Home Phone

Other Phone

Street Address

City

State

Zip Code

Length of Time at Current Residence

Home Facts Home Facts Rent Own Other

Landlord's Name (if applicable)

Landlord's Phone (if applicable)

If renting/leasing, does your lease allow pets? If renting/leasing, does your lease allow pets? Yes No

Do you have a fenced yard? Do you have a fenced yard? Yes No

Employer

Employer's Phone

Occupation

Does anyone have pet allergies? Does anyone have pet allergies? Yes No

Does everyone in the household want a pet? Does everyone in the household want a pet? Yes No

In addition to yourself, who lives with you and how old are they?

Describe your family’s level of activity. Do you enjoy fun outdoors or quiet time at home? What activities would the dog be doing with your family?

Describe the area where your animal(s) will be kept

Who will care for the animal(s) when you are not home?

Do you have any pets currently? Do you have any pets currently? Yes No

If you do not have any pets, have you had any before? If you do not have any pets, have you had any before? Yes No

Please list your current pet(s): species, breed, age, sex, if they are spayed or neutered and if they are current on their vaccines

Have you ever housebroken a pet before? Have you ever housebroken a pet before? Yes No

Do you know what crate training is/have you used this method before? Do you know what crate training is/have you used this method before? Yes No

Name of your current vet

Phone of your current vet

Address of your current vet

Please be aware that owning a dog is a big financial responsibility. Regular vet visits, food, training, toys, medical bills, etc. cost an average of $800 per year. Are you willing to take on the financial responsibility? Please be aware that owning a dog is a big financial responsibility. Regular vet visits, food, training, toys, medical bills, etc. cost an average of $800 per year. Are you willing to take on the financial responsibility? Yes No

Most dogs live for 10-20 years, depending on the breed, and we only adopt to families who are willing to make that kind of commitment. Are you prepared to make such a long-term commitment? Most dogs live for 10-20 years, depending on the breed, and we only adopt to families who are willing to make that kind of commitment. Are you prepared to make such a long-term commitment? Yes No

Name of a Personal Reference

Phone of Personal Reference

Address of Personal Reference