Any field with an * requires input for successful transmission. Any field with a yes, no or N/A field also requires an answer. List name of dog you are applying for *
Personal Information
Your Name.*
Your Age.*
Address.*
City, State and Zip.*
Phone Number. *
Email Address.*
Occupation.*
Employer.*
How soon do you want to adopt?*
Why are you interested in this particular dog?*
Have you owned a dog before? *
If yes, provide a brief history of any previously owned dogs (not current dogs).*
Have all members of the household been informed of your decision to adopt a dog?*
If no, please explain.
Who will be the dog's primary caretaker? Children cannot be expected to be the primary caregiver. The primary caretaker's responsibility is to make sure the dog is fed, watered, and exercised as well as emotionally and medically cared for.*
Household Info
How many people in your household and their ages?*
If there are no children at home, are there children that frequently visit? Ages?*
Do you own your own residence?*
If you rent, you must have permission from your landlord. Do you have permission yet?
Landlord Name.
Landlord Phone.
Landlord Address.
Does anyone in the home have allergies to dogs?*
How many pets currently live in the household?*
Are all resident pets up to date on vaccines, if no pets answer N/A?*
Pet 1
Name.
Breed.
Age.
Sex.
Spayed or Neutered*. yesnon/a
How long owned?
Where does the animal sleep?
Pet 2
Spayed or Neutered. yesnon/a
Pet 3
For additional pets, please enter here.
Vet Reference
Please provide contact information for a vet you have used. Personal references may be requested later in the process.
Vet Name.
Vet Phone.
Vet Records under the name of:
Concerning the Dog
Do you have a fenced in yard?* yesno
If not, how do you plan to have your dog relieve itself?
How do you plan on giving your dog proper exercise?*
Dogs sometimes have accidents inside; what are your thoughts on housetraining?*
What activity level are you looking for in a dog?*
Do all adults work full time?* yesno
How many hours will the dog be alone?*
Most dogs bark, at least a little. What do you consider an acceptable level of barking?*
Where will the dog be kept when home alone (crated, run of house, gated, in a room, outside?)*
Where will the dog sleep?*
If needed, are you willing to go to a dog training class or hire a trainer.* yesno
Any additional info you would like us to know?
Adoption Fees
The adoption fees range from $250-500 for most of our dogs (decided on a case by case basis). This helps defray the cost of veterinary care which includes spaying, neutering, shots and any other medical care we provide prior to adoption. All our dogs are spayed or neutered prior to adoption. Do you agree? * yesno
For our records, how did you hear about All Dog Rescue?*
