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Adoption Application

Contact Us

Name:

Message:

Address:

City

State

Zip

Phone:

Email:

Housing Situation:

Housing Type:

Landlord Name & Phone (if applicable):

Length of Time at Address:

Others Living in Household (include ages of children)

Pet History

Pet History

What animals do you currently own?

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Animal 1

Species

Age

Neuter/Spayed

Kept in, out, or both?

How long have you had this animal?

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Animal 2

Species

Age

Sex

Neuter/Spayed

Kept in, out, or both?

How long have you had this animal?

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Animal 3

Species

Age

Sex

Neuter/Spayed

Kept in, out, or both?

How long have you had this animal?

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Additional Pet Details

Any other animals?

Are your pets current on their vaccinations

Name of your veterinarian

Phone number of your veterinarian

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Dog Specific Questions

What is your experience with dogs?

Please rate your household activity level

Where will the dog be kept during the day?

Where will the dog be kept at night?

Do you have a fenced in yard?

Length of time the dog will be left alone

Reasons for adopting

Age Preference

Under 6 months

Over 6 months

Over 1 year

Senior

No Preference

Size Preference

Small (under 20 lbs)

Medium (20-50 lbs)

Large (over 50 lbs)

Do you have a specific breed preference?

Coat Preference

Short hair

Medium hair

Long hair

No preference

Dog Activity Level

Sex

Will you be taking the dog for training?

Availability to exercise the dog

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By submitting this application, you agree to the following:

I understand that when I adopt a rescue animal very little, if anything, will be known about the animal’s past. I have to assume that the animal was never house-trained and will need my calm and gentle assistance in learning this new behavior.

Thank you for contacting us.
We will get back to you as soon as possible.

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