EmailMe Form - Dog Adoption Application

Date Time *

MM / DD / YYYY

Name of dog you're interested in adopting *

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

This should be your permanent residence. If moving then include the new address as well.

Phone *

### - ### - ####

Email *

Age range *

Marital Status *

In the unfortunate event of a break up, what will happen to the dog? *

Do you rent or own your home? *

How long have you lived here? *

If you rent, please provide your landlords name and phone number

Are you aware of any breed restrictions, deposits or fees?

Do you live in town or in the country? *

Does your city/town have a restriction on the number of pets allowed per household? (Some cities have a 2-3 dog minimum.)

Is your yard securely fenced? if so please describe your fence. If no fence, please describe how you will plan to take your new dog out for potty/exercise. *

Does anyone in the home smoke? *

Activity Level *

Do you have children? *

If you have children, please list ages. Or specify if granchildren visit. *

When are you ready for your new dog? *

What are you looking for in a new dog? *

Work *

Please describe your daily schedule: *

How many hours per day are you away from home? *

Where will the dog be kept when no one is home? *

Where will the dog be when you are home? *

Where will the dog be kept at night? *

How often do you plan to exercise the dog? are you physically active? what types of activities do you plan to do with your new dog? *

Do you have any training experience? Please describe. (potty training, anxiety, fear, etc) *

Are there any behaviors you are not willing to work with? *

Are you interested in going to obedience classes? We work with a trainer who offers discounts to adopters and also does boarding. *

Are you willing to work with a dog/puppy who is not fully potty trained? Some of our dogs come from shelters and have never been inside a home before. *

Who will care for your dog when you go out of town? *

Under what conditions would you give up your dog? *

What type of pack leader are you? *

Please list any current pets. Include age and if spayed/neutered. *

Please list any previous pets from the last 5 yrs. and why they are no longer with you. *

Have you ever adopted from us or another rescue organization? If the pet is no longer with you, please explain. *

Current or previous Veterinarians name and phone number. Or who you plan to use if you do not have one. *

Please provide a personal reference. Name and phone number or email address. *

Feel free to use this space to describe what you are looking for in your next dog! If we don't have a good match then we are more than happy to help find the perfect new family member.

This application is not a guarantee that you will be approved. And is in no way a binding contract. This is for informative purposes only to help us find the best match for your family, lifestyle and activity level. We require a home visit and meet n greet with the dog to ensure it will be a good fit. Everything we do is in the best interest of our dogs and we work to find forever homes for each and every one of them.

Please do some homework if you are new to a certain breed and make sure you are prepared for a 15+ yr commitment. Rehoming is very hard and stressful on these dogs, especially the ones who come from the shelters or have been bounced around already.

Thank you for your interest in adopting one of our amazing dogs! We look forward to helping you find the perfect match.

Signature (Please type your name) *