Dog Adoption Application

Name
Street Address
City
State
Zip Code
Cell Phone
E-Mail Address
Name of the dog(s) you want to adopt If you're applying for a puppy, please list a 2nd and 3rd choice as well.

Do you live in (select one):
Do you want this dog to be (select one):
Where will this dog be kept during the day?
At night?
When you're not home?
Do you have a fenced in back yard?
If there is no fenced in yard, how will you exercise the dog?
Please tell us why you would like to adopt a dog?
Please list all the people your dog will be living with (including yourself)
Please include name, age, and relationship to prospective adopter.
Did your entire family agree on the adoption of this one dog?
Are there any children that visit your home frequently?
If yes, please list their age(s)
Do you have any other pets living with you now?
If yes, please list them Include type (dog, cat, etc.), breed, and whether they are neutered/spayed.
Do you have a regular veterinarian?
If yes, list clinic name, address, and phone number
May we have permission to request information form your veterinarian?
What do you know about heartworms?
What will you feed your new dog?
What kind of behavior do you find unacceptable?
If the dog has problems with behavior, what will you do about it?

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