Dog Adoption Form Dog Adoption Form Name * Name First First Last Last Address * City * State * Zip Phone * Phone 2 DL# Date of Birth * Email * Place of Employment * Length of Employment * Number of Children at home * Ages of Children * Emergency Contact Emergency Contact * Emergency Contact First First Last Last Phone * Relationship * Do you * Own Rent Is it a * Home Apartment How long have you lived there? * How long did you live at your previous address? If you rent, has your pet deposit already been paid? Yes No Landlord’s Name/Complex: Landlord's Phone Are you planning to move in the next 6 months? * Yes No What will happen to this pet if you move unexpectedly? * What are your plans for the pet if you have to evacuate? * I want this pet to be * Inside only Outside only Inside/Outside Do you understand crate training? * How many hours during the average day will the dog be without a human? * Do you have any pets now? * None Dogs Cats Other How old are they? Have you had other pets? * Yes No How long have you had them? Are your current pets spayed and neutered? Yes No If no, why not? If you have a regular veterinarian other than us? What is the Name & Number? What kind of pet behaviors do you find unacceptable? * How will you handle them? * Do you have a fenced yard? * Yes No How will you excercise your dog? * What will you feed your dog? * Submit If you are human, leave this field blank.
