If you are human, leave this field blank.
Where did you hear about us?
Name of dog(s) you are applying for?
Your Spouse's/Partner's Full Name (first and last):
Are you 21 years of age or older?
How long have you lived at this address?
Place of Employment:
Work Telephone Number:
Are you moving in the foreseeable future?
If Yes, when are you moving, and what will happen to your dog?
Number of Adults:
Number of Children:
Which members of your household will be responsible for the care and training of the dog?
What are your reasons for wanting to adopt this dog or pup?
Please list your current pets', name, age, breed, sex, owner listed on Vet records:
Are all of your animals current with their vaccines?
Which of your current pets have not been spayed/neutered and please let us know why?
Who is your current veterinarian?
Current veterinarian's phone number?
Have you adopted from a shelter or rescue group before?
Name of Shelter/Rescue Group:
Location of Shelter/Rescue Group:
Is someone home during the day?
If Yes, please give details:
If not, for how many hours will the dog be alone including commute time?
Describe where the dog will be when you ARE home-which room(s), yard, dog house, garage, basement etc.
Describe where the dog will be when no one is home-- (rooms, yard, dog house, garage, basement, doggie daycare, take to work etc.)
Where exactly will the dog sleep at night?
If adopting a puppy, who will do the housebreaking and how will this be accomplished?
Are you looking for a dog who will be trustworthy off-leash?
If yes, in what situations?
And if yes, how will you train the dog to be safe off-leash?
Please tell us about all the people the adopted dog would usually come in contact with (baby sitter, extended family, children, visitors, roommates etc.)
What arrangements will you make for the dog when you travel or are on vacation?
Under what circumstances would you feel it necessary to give up or return a dog?
Is there a baby in your future? (If so we'll send information on helping your dog adjust to a new baby.)
I plan to let my dog get exercise:
I will provide the dog with:
My dog or puppy needs to be comfortable in a crate all day.