Dog Adoption Application

To adopt a dog from AAA.....

1.) MUST LIVE IN THE LOS ANGELES AREA: Unless otherwise discussed in advance, we will only consider Los Angeles area adoptions. If you do not live in the LA area please check with us before filling out an application.

2.) ADOPTION DONATION & CONTRACT: If we approve you for adoption of a dog or puppy we ask for a minimum donation of $250 and a we require a signed adoption agreement.

3.) MUST BE 21: Applicant must be at least 21 years old and/or head of household.

* Today's date:

* Name of the dog you want to adopt OR describe what you are looking for in general:

* Name (First AND last):

* Street Address

* City

* State

* Zip Code

* Phone Number

* Email Address

* What is your age range?

* What is your occupation and/or what company do you work for?

* Please list the name of each person living in your home. Please specify their relationship to you (spouse, parent, child, etc.) Anyone under 21 years old please specify their age.

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

No

Yes

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

* What type of behavior/characteristics/energy are you looking for in a dog? (e.g., lap dog, hiking partner, playful, etc.):

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* Will you allow a member of Animal Advocates Alliance to come to your home for a "home check"? (If no, please explain)

Yes

No

* In what type of dwelling do you live?

* Do you own or rent? (If you rent please provide landlords name and phone number)

Own

Rent

* How long have you lived at your current residence?

* Please describe your yard enclosure including what material the fence/wall is made of, how high the fence/wall is at it's lowest point and at it's highest point, the height and material of all gates and what kind of latch or lock the gates have. (If you live in an apartment and/or don't have a yard please specify this)

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* Do you have a dog door? (If yes, please specify when the dog would have access to the dog door- 24/7, day only, night only, only when home alone, etc.)

No

Yes

* How many hours a day will your dog be left without human companionship? (Please provide as much detail as possible about your schedule with regard to the animal being home alone)

* Please provide a detailed explanation/description of the area where you plan to leave your dog when he/she is home alone.

* Please provide a detailed explanation/description of the area where you plan for your dog to sleep at night:

* Will there be times when the dog is tied up? (If yes, please explain when and where, for how long and why)

* Do you have a pool? (if you have a pool please specify if the pool area is enclosed seperately from the rest of the yard.)

No

Yes- pool area DOES have its own enclosure/fence

Yes - pool area does NOT have its own enclosure/fence

* Will you allow the dog to ride in the open back of a pick up truck, jeep or convertible? (If yes, please explain)

No

Yes

* How will your dog be cared for when you go out of town?

Petsitter stays at my house

Dog will stay at friend/family members house

Dog will stay at a kennel

Dog will stay at the veterinary hospital

Dog will stay at cage free daycare

Neighbor/friend will stop in to feed/check on dog

Other

* What provisions will you make for your dog in the unfortunate event that you become unable to care for him/her? (EX: you become ill, you are in an accident, you experience finacial difficulty, etc.)

* Under what circumstances would you consider giving up/getting rid of your dog? (check all that apply)

* Please list ALL pets that you CURRENTLY own. Include the following information: breed, age, gender, length of time in your care, indicate if they are or aren't spayed/neutered.

* Please list ALL pets that ALL adult family members have PREVIOUSLY owned. Include the following information: breed, gender, indicate if they were or weren't spayed/neutered, length of time you owned them, what happened to them (if they died please indicate how, if you gave them away please indicate circumstances):

* Are your current pets up to date on vaccines? (If no, please explain)

Do not have any pets

Yes

No

* Have your previous and/or current pets been obedience trained? (If yes, please state where/with who the dog was trained)

No

Yes

* Have you ever surrendered a pet to an animal shelter? (If yes, please explain)

No

Yes

* Have you ever had a pet euthanized? (If yes, please explain)

No

Yes

* Have you ever allowed a pet to breed (get pregnant or impregnate another dog) ? (If yes, please explain)

No

Yes

* 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? (If yes, please state when you applied and describe the outcome)

No

Yes

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

* Are you willing and able to exercise your dog on a daily basis? (If no, please explain)

Yes

No

* Are you willing to enroll your new dog in obedience/behavior training if necessary? (If no, please explian)

Yes

No

* What methods will you use to dicipline your dog?

* Please provide the name, city & phone # of your veterinarian or animal hospital:

* Is there a limit on the amount you are willing to spend on your dog's veterinary care on a monthly, yearly or per-incident basis? (If yes, please explain)

No

Yes

* Would you consider putting your pet to sleep if he/she required a surgery/treatment that is beyond what you are able/willing to spend? (If yes, please explain)

No

Yes

* Would you obtain medical insurance for your pet? (If no, please explain)

Maybe

Yes

No

* 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? (If no, please explain)

Yes

No

* 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


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