Dog's name(first choice):
Dog's name(second choice):
Your name:
Your address:
City - State - Zip:
Your employer:
Your occupation:
Name of Spouse/Partner:
Spouse/Partner's employer:
Number of adults in your home:
Ages of the children:
Type of dwelling:
House
Apartment
Condo
Live With Parents
Other
Landlord's name:
Description and sex of dog(first choice):
Description and sex of dog(second choice):
Home Phone #:
Cell Phone #:
Your e-mail address:
Employer's phone #:
Date of birth:
Spouse/Partner's occupation:
Spouse/Partner's employer's phone #:
Number of children in your home:
Is everyone in the house in favor of this adoption?
Yes
No
Do you rent or own:
Rent
Own
Landlord's phone:
If you live with your parents, regardless of age, we must have parental consent:
Parents :
Is this your first pet?
Yes
No
Veterinarian's / Clinic name:
Name(s) of animals taken there:
Are they all current on heart worm meds?
Yes
No
N/A
Number of cats you own now:
Number of other animals you own now:
Is this dog a gift?
Yes
No
Will the dog be an indoor or outdoor dog?
Indoor
Outdoor
Indoor/Outdoor
Where would your dog be kept during the day?
Indoor
Outdoor
Indoor/Outdoor
Do you have a fenced yard?
Yes
No
Primary reasons for adopting this dog:
Parent's phone # :
Are you 18 years of age or older?
Yes
No
Veterinarian's / Clinic phone #:
Are all your animals spayed or neutered?
Yes
No
N/A
Are all your animals current on their shots?
Yes
No
N/A
Number of dogs you own now:
Is anyone in the household allergic to animals?
Yes
No
Do you agree to spay or neuter?
Yes
No
Where would your dog be kept during the night?
Indoor
Outdoor
Indoor/Outdoor
If you dog is outside, what type of shelter will you provide?
How high is your fence?
Have you had pets in the past?
Yes
No
Pet History
1. Type of pet - How obtained - How long kept - What happened to the pet?
2. Type of pet - How obtained - How long kept - What happened to the pet?
3. Type of pet - How obtained - How long kept - What happened to the pet?
Have you adopted from a shelter or animal organization before?
Yes
No
If yes, which one and where.
Have you ever turned an animal into a shelter or animal organization?
Yes
No
If yes, it was
Our Own
A Stray
Shelter name
If you move or become incapacitated in the future is there someone who will take your dog?
Under what circumstances would you not keep this dog?
Animals are as individual as people. Are you willing to spend the time and effort helping this dog adjust to your home and lifestyle?
Yes
No
Would you permit an onsite premise check?
Yes
No
This is only an application. If you pass the application process and inspection you will have to sign a contract and pay an adoption fee before receiving one of our Treasured Friends. We accept multiple applications on all animals. We reserve the right to place a pet in the most suitable home for that pet's temperament.
Before clicking send please make sure all questions have been filled in. If something does not apply please place na or non applicable in that space.