Adoption Application

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Name: Address: City: State: ZIP Code: E-Mail: Please Enter Your Email Address Again: Home Phone: Work Phone: A home inspection is required before the adoption process can be finalized. Do you agree to allow us to do a home inspection? ?   YES    NO What is your age category? Under 18 18-25 26-30 Over 30 Why do you want to adopt a dog? Are you adopting this dog for yourself or as a gift for another person? If the dog is to be a gift, what is your relationship with this person? Do you currently own any other pets? If so, what kind? If you currently own any other cats or dogs, are they up to date on their vaccinations and properly licensed with the county?   YES    NO If you currently own any other cats or dogs, are they spayed/neutered? If they are not spayed or neutered, why not? If you currently own any other dogs or cats, what type of heartworm preventative do you currently use? If you currently own any other cats or dogs, where do they primarily stay? Have you owned any other cats or dogs in the last five years that you no longer own? If so, what happened to them? What is the name and phone number of the veterinary hospital at which your animal(s) has/have received care and vaccinations? How many people currently reside in your household? 1    2    3    4    5    Over 5 What are the ages of any children living in the household? Who will be responsible for feeding the dog and taking it outside? Please describe your dwelling. Home    Apartment    Condominium    Mobile Home    Other    Do you own or do you rent?   OWN    RENT If you rent, what is the name and telephone number of your landlord? Do you have a fenced yard? If so, what type of fence is it? How high is it? How much time will this dog spend outdoors during a normal 24 hour period? How many hours will this dog be left alone during a normal 24 hour period? When you are home, where will the dog be kept? (outside, crated, loose, confined in a single room, etc) When no one is home, where will the dog be kept? (outside, crated, loose, confined in a single room, etc) Where will the dog sleep at night? If we do not currently have the type of dog you wish to adopt, please tell us below what you are looking for (breed, size, age, sex, housebroken, etc).

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