Dog Adoption Application

Dog's Name*

 Dog Adoption Form Download

Name*

Date of Birth*

Address*

City*

State*

Zip Code*

Home Phone*

Cell*

Work*

E-mail*

Place of Employment*

Todays Date*

Do you rent?YesNo

Landlord/lady's name:

Landlord/lady's phone:

How long have you lived at your present address:

If you move in the future, will you ensure the residence allows pets?YesNo

If needed, do you have approval to have a dog in your home?YesNo

Name of vet Clinic:

Phone #:

Do you have training or behavioral modification experience?YesNo

If so, elaborate:

Experience with:Resource GuardingDog AggressionChewingLeash ReactivityCage ReactivityAnxietyGeneral FearfulnessGeneral Command TrainingFear of StrangersJumpingLeash EtiquetteSocializingNippingHouse Training (peeing/pooping)

If not, are you able to put your dog in training classes?YesNo

If you are adopting a puppy, are you able to put then into puppy socialization classes?YesNoN/A

Describe where you will be keeping the dog(s), including how you will separate them from your own animals, if applicable:

Approximately how long, on an average day, will dogs be left alone in the home (without people to monitor eating, behavior and elimination)?

Previous experiences with animals:

Are you currently or have you previusly adopted from any other humane organization? If so, which one?

Have you ever surrendered a pet before?YesNo

If so, Why?

Anything else you would like to share about yourself or your experience?