Dog Adoption Application

Dog Name

Personal Information:

Name

Phone

Date

Age

Spouse/Partner Name

Phone

Address

City

State

Zip

County

Current Employer

Email Address

What qualities are you looking for in a dog?

Current Living Situation

Do you rent or own your home?

If you RENT or LEASE, please provide the following landlord/owner’s information:

Name

Phone Number

Do you have landlord’s approval to have pets?

What’s the pet deposit?

Type of residence (please check one):

How long have you lived at this address?

Are you planning to move in the next 6 months?

Are there any weight or breed restrictions where you live?

Is there a fenced yard?

If yes what type? (height, chain link, wood etc)

How do you plan to exercise your dog?

What is the activity level of your household?

Number of adults in home

Number of children living in home and ages

Number of grandchildren/visiting children and ages

Who will be the primary caretaker?

Does anyone residing in the house have any known pet allergies?

If you must move from your current place of residence, what will you do with your dog?

What will you do if you decide to move to a place that does not allow pets?

Veterinary Information (for owned and previously owned pets)

Clinic Name

Phone Number

If you do not currently have a veterinarian, you will be asked to obtain one before the adoption is finalized.

Please list CURRENT PETS and Pets you’ve owned IN THE PAST 5 YEARS:

PET 1

Name, Age, Breed

PET 2

Name, Age, Breed

PET 3

Name, Age, Breed

PET 4

Name, Age, Breed

PET 5

Name, Age, Breed

Are the pets you now own current on vaccinations?

Are the records listed under the name on the application?

If you no longer have the pet, what happened to it?

How do you plan to introduce your new foster dog/puppy to the other pets in your household?

Pet care philosophy and training

Why do you want to adopt a dog?

Have you ever surrendered an animal to a shelter?

When?

Why?

How much $ do you plan to spend per year to care for your dog?

If your pet comes down with a serious medical problem in the future that is very expensive, what would you be willing to do? What could you realistically afford?

What brand heartworm and flea preventative do you use?

What brand dog food do you currently feed or will you feed?

How will you correct behavior problems in your dog if they occur?

How many hours a day will your dog be without human companionship?

Are you a frequent traveler?

Who will care for your dog during vacations, business trips, etc?

Where will you keep the dog during the day when you are home?

Where will you keep the dog during the day when you are gone?

Where will you keep the dog during the night?

When do you think it’s okay to allow a dog off leash?

Where will you keep the dog during the night?

What are your house training methods?

Do you have experience with crate training?

Are you willing to attend obedience classes with your new dog?

How long will you allow your dog adequate time to adjust to a new home?

Have you ever had a situation where you had to find your pet another home because of a move, new baby or behavior problem, etc? Please explain:

Under what circumstances do you find it acceptable to find your dog another home? Check all that apply:

Please explain:

Have you ever had a serious behavioral problem with a pet? If so, what did you do?

What will you do if your dog has behavioral problems in the future?

Do you expect any major life changes in the next 10 years – marriage, children, etc?

How do you think these life changes will affect your pets?

Are you aware of the annual routine vaccinations recommended and those required by law for the health and protection of your dog? And do you plan to take your dog to the vet for yearly checkups and vaccinations?

This dog/puppy is being adopted as: PLEASE CHECK all that apply.

Will you commit to caring for your new dog for the next 10 - 15 years?

Are you familiar with the dog responsibility and liability laws in your area?

Do you understand that all adopted dogs must be spayed/neutered?

Would you agree to an in-home visit with a volunteer before, during or after the adoption is approved?

Please provide two personal references that we may call and verify the information above:

Name & Phone Number

Check items you would like more information about.

By signing below, you agree that you are applying for this dog for yourself and no one else and this dog will be living only at the above address listed above.

Signature & Date

SOUTHERN ANIMAL RESCUE