Welcome to the Online Application for adopting a pet. Please complete the entire application so that we can review it and provide you with a great pet.
Choose a Date *
Name of dogs you are interested in:
Name *
Address, City, State, Zip *
Age
Home number *
Cell phone
Email address *
What is your Occupation?
Length at Occupation.
How many days a week & hours a day do you work?
Name of Spouse, Significant other, partner, or roommate:
Select Relationship of this person: Select Spouse Significant Other Partner Room mate
Partner's Email Address:
Partners Cell Number
What is your partner's occupation?
Partner's length at occupation?
How many days a week & hours a day do they work?
Who would keep the pet if the relationship ends?
In General, why do you want a dog?
Is every member of the family in agreement to adopt this pet? Yes No
If you had to suddenly relocate or had other drastic lifestyle changes that made it hard to keep your new pet what would you do with him/her?
What will you do if you can no longer keep your rescue dog?
Are you prepared to make a commitment of 10-16 years? Yes No
What type of home do you have? House Condo Apartment Townhouse Duplex Mobile Home Boat
Do you own, rent or lease your home? Own Rent Lease
Landlords Name
Landlord's Phone number
How long have you lived at your current address:
Is your yard fenced? Yes No
What type of fencing do you have?
Height of back fence?
Height of Front Fence?
Do you have a pool? Yes No
Is there a fence around your pool? If yes, please provide height.
How many adults (over 21) live at this residence?
How many children (under 21) live at this residence?
If applicable, Names & ages of all children
Is anyone allergic to cats or dogs? Yes No
Do you have a dog door? Yes No
If no, will you install one?
Full name
Relationship to you?
Their phone number?
Will your dog be a: Family Pet Home Protection Children's dog A Gift Work Protection Companion for other pet Guard Dog
What kind of outside shelter do you have?
Percentage of time dog will be:
Where will your dog sleep, be specific
Do you have plans for your pet, should it outlive you, to assure it won’t end up in the shelter? Yes No
Name of new owner:
Phone of new owner:
Have you ever given up a pet before? Yes No
If yes, where did it go?
Have you ever lost a dog or had one stolen? Yes No
If yes, explain:
Do you have a vet? Yes No
Current vets name, address, and phone number:
Who will be responsible for feeding, housebreaking & training?
If you rescue dog is not housebroken, how will you house train it?
How will you deal with potential issues of your dog such as; fear, chewing, digging, barking, separation anxiety, walking on leash, etc.?
Do you plan to take this dog to obedience class? Yes No
Is someone home during the day? (Please explain)
How many hours a day will your dog be left alone, explain
When I am home this pet will be kept (explain)
When I am not home this pet will be kept (explain)
Where will your dog spend his day (explain)
Name the dog breeds you have owned since you were 21.
How long did you own them and where are they now?
Do you have a dog now? Yes No
Please list breed, sex & age of current dogs.
Are they spayed/neutered? Please Choose Yes No
Explain why pet is not fixed.
What other pets do you have?
Are they spayed or neutered? Yes No
Explain why other pets are not fixed:
If you no longer have your pet, what happened?
Is there anything else that you would like for us to know?
How did you hear about us or specific website?
Thank you for submitting your application. We will review all the information and we will be in contact with you shortly.
In the meantime, feel free to visit other parts of the site.
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