Dog Adoption Application

Thank you for your interest in adopting one of our animals. The information requested in this questionnaire will help us determine whether the placement is in the animal's best interest, and assist you in finding the animal most compatible with your lifestyle. Following are a few important points to keep in mind:

--There is a $250 adoption fee for all dogs and puppies, which helps us cover the cost of spay/neuter, vaccinations, microchipping, and temporary boarding.

--An approved home check and signed adoption contract are required to adopt a pet.

--If you are currently renting, we will contact your landlord to ensure that he or she will allow you to keep an animal on the premises.

--All dogs (no matter how small) require daily exercise. You must make every effort to walk your dog for at least 30 minutes every day; two walks per day is ideal.

--Dogs have life expectancies of at least 10-15 years. You must be able and willing to invest the time and money necessary to properly care for your new pet for the rest of the animal's life, which could include training, grooming, boarding, medical or surgical treatment, long-term medications, and/or a special diet.

* Name of animal you want to adopt:

* Name of Applicant (First & Last name):

* Address (include street address, city, state, zip):

* Phone #(s):

* Email address:

* Your Occupation:

* Name & Phone # of Employer:

* Reference #1- Name, Phone #, Years known:

* Reference #2- Name, Phone #, Years known:

* Why do you want to adopt a dog? (check all that apply)

* What type of behavior are you looking for in a dog? (e.g., lap dog, energetic, playful, etc.):

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* With whom do you share your household? (list names, number of adults, number of children and children's ages):

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* Are any members of your household allergic to animals? (if Yes, please explain)

No

Yes

* In what type of dwelling do you live?

* Do you own or rent?

Own

Rent- please provide landlord's name & phone #:

* Are you willing to allow a member of Animal Advocates Alliance to come to your home to see where the dog will be living?

Yes

No- please explain:

* Does your home have an enclosed yard?

No

Yes- what type of fence & how is the gate secured:

* Do you have a dog door?

Yes

No

* How many hours a day will the dog be left without human companionship? Explain:

* Where will the dog be kept when he/she is home alone?

* Where will your dog sleep?

* Will there be times when the dog is tied up? For how Long? Please explain:

* Do you have a pool?

No

Yes- is pool enclosed?

* Will there be times when the dog is kept outside or in the garage for extended periods?

No

Yes- please explain:

* Will you allow the dog to ride in the open back of a pick up truck, jeep or convertible?

No

Yes- please explain:

* If you do not take your dog with you when you go on vacation who will care for the dog when you are gone?

* If you move will you take your dog with you?

Yes

No- please explain:

* What provisions will you make for the dog if you become unable to care for him/her?

* Which of the following do you believe are acceptable reasons to give up a dog? (check all that apply)

* What types of pets, if any, have you had? (List each pets name, gender and breed and indicate if they were or were not spayed/neutered. Indicate whether any of these pets are still living with you. If you no longer have the pet, describe what happened to them.)

* Have your previous and current pets been obedience trained?

No

Yes- where/with who:

* Have all of your previous and current pets' vaccinations been kept up to date and do you plan to keep your new pets' vaccines up to date?

Yes

No- please explain:

* Have you ever surrendered a pet to an animal shelter?

No

Yes- please explain:

* Have you ever had a pet euthanized?

No

Yes- please explain:

* How do you anticipate your current pet(s) will react to the new dog? (if you do not have any pets please write "N/A")

* Have you ever applied to adopt an animal from another rescue organization?

No

Yes- when? what was the outcome?:

* If your new dog/puppy is not housetrained what methods will you use to train him/her? Please explain:

* Are you willing and able to exercise your dog on a daily basis?

Yes

No- please explain:

* Are you willing to enroll the dog in obedience or behavior training if necessary?

Yes

No- please explain:

* How will you discipline the dog? (Stern voice, swat nose, swat buttocks with hand or newspaper, etc.) Please be specific:

* Name, city & phone # of your chosen veterinarian or animal hospital:

* Are you prepared to cover any medical expenses the dog may incur throughout his/her life?

Yes

No- please explain:

* Is there an upper limit on the amount you are willing to spend on the dog's veterinary care?

No

Yes- how much, please explain:

* Would you consider euthanizing an animal if the cost of veterinary care became too high?

No

Yes- please explain:

* Are you prepared to take responsibility for this dog for the rest of his/her life, knowing that dogs have a life expectancy of at least 10-15 years?

Yes

No- please explain:

* Is there anything else you would like us to know? Please add any additional information you want us to consider when we evaluate your application:

* Indicates Response Required