ADOPTION APPLICATION
How did you hear about us?
Adopt-A-Pet
Petfinder
Craigslist
Internet Search
Interested in a Specific dog? Enter name here
Name
*
Prefix
First
*
Last
*
Suffix
Address
*
Street Address
*
Address Line 2
City
*
State / Province / Region
*
Postal / Zip Code
*
Country
*
Phone Number
*
###
-
###
-
####
Email
*
Do you:
*
Own
Rent
If Renting, do you have permission from the landlord to have a dog?
Yes
No
Landlord's Name and Phone Number
Do you have a yard?
*
Yes
No
If you have a yard, please indicate if it's enclosed and the height of the fence surrounding it
*
Where would your new dog spend his/her time majority of the day?
*
How many hours do you spend away from home?
*
1 to 4 hours
5 to 8 hours
9 to 12 hours
12 plus hours
Majority of our rescue dogs are puppies 6 months and under; Have you done the proper research on all the care a puppy requires?
*
Yes
No
Do you have any other pets? If so, how many and what kind?
*
Would you oppose a house check prior to adoption?
No
Yes
Undecided
I certify that I am an adult (18 yrs & over) and primary home owner/renter and that all information in this application is true. I understand that false information will void this application. I agree that upon adopting a pet from Wholesome K9 Rescue & Adoption Inc., I will agree and abide by their adoption agreement.
*
Yes, I certify that this is true.
Image Verification
Please enter the text from the image
:
[
Refresh Image
] [
What's This?
]
Powered by
EMF
HTML Contact Form
Report Abuse