Name
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First Name
Last Name
Are you applying to adopt or foster?
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Name or type of dog you are interested in?
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Are you interested in talking about other dogs(breeds) than the one mentioned above?
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Email
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Phone
*
(###)
###
####
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Please list the name, age and gender of all adults in household: (18+, including yourself)
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Age of minors in household: (17 or younger)
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Has adding a new pet to the family been agreed upon by all adults in the household?
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Do you have any trips, major medical procedures, or major life changes planned within the next four months?
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If yes, please explain how the dog will be taken care of during this time.
Do you rent or own your home?
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Are you open to a home visit?
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Do you have a fenced in yard?
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This does not disqualify your application.
If yes, please describe the type of fence
How many hours a day would your dog be alone?
*
Please list any animals you currently have in your home:
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Name, Age, Breed, how long you've had them
If you've had any animals in the past, describe them:
Name, why you no longer have them, what were they like
We require that current/previous animals are/were up to date on vaccines, kept on flea/tick/heartworm prevention year round, and spayed or neutered
If your animals do not meet those requirements please explain why:
Are you able and willing to work with a trainer if necessary?
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Veterinary Office Information:
Veterinary Phone Number:
(###)
###
####
The name your records can be found under:
ATTENTION: Please make sure to call your vets office and references to give them permission to speak with us and to let them know we will be calling!!!
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If you do not have a vet please explain why:
Non-relative reference #1
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Name, relation, phone number
Non-relative reference #2
*
Name, relation, phone number