Dog Adoption Application Word Document
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froshtegaDog Adoption Application Word Document
Uploaded by
froshtegaDOG ADOPTION APPLICATION
Name: Date:
Address: City: Zip:
Home Phone Cell Phone Work Phone
Thank you for considering the adoption of a shelter animal! Before you decide to adopt a pet, please consider the time, effort
and funds (estimated at $1000 or more annually for food, supplies, vaccination, and veterinary care) necessary to property
maintain an animal. Responsible pet ownership requires a commitment to provide care and companionship for the life of the
animal. The decision to adopt a pet is an important one. In order to ensure that you and your pet will be happy for years to
come, we need to take time to discuss your and the animal s individual needs and personality traits. Please take a few
moments to carefully read and complete this application.
Do you currently live in a: House Apartment Condo Other
Do you currently. Own Rent Lease The residence where you live?
How long have you lived at your current residence?
If you are not the property owner, If you’re not the property owner kindly fill this in as well
Landlord s Name: Phone
Number:
Please include area code
How many adults live in your home? How many children? Ages?
Does anyone in your household have allergies? Yes No
Who will be primarily responsible for the care of this dog?
Is this dog a gift? Yes No If yes, for whom?
Which of the following best describes your reasons for wanting this dog? (Check all that apply)
Companion Guard Dog Hunting Breeding Obedience Training
Search & Rescue Agility Jogging/Walking Buddy Couch Potato
How many hours will the dog be alone each day?
Continued on next page
Dog Adoption Application — Page 2
Applicant Name:
Where will the dog be kept when no one is at home?
Where will the dog be kept at night?
Do you have a fenced yard? No Yes If so, how high is your fence?
Type of Fence:
If you have other pets, are their vaccinations current? Yes No
If required, are they currently licensed?
Yes
Do you have a veterinarian? No Vet s Name:
Under what circumstances would you NOT keep this dog?
Please list all of the pets you have had in the last ten years including current pets and those you no longer own:
Breed Age Gender How long owned? Do you still have it? If not, what happened to it?
I like dogs that are: Any Small Medium Large Size
Please describe the temperament and activity level you are looking for in a dog: (Check all that apply)
High Energy Outdoorsy Lap Dog Affectionate Quiet
Mellow Affectionate Guard Dog Service Dog Therapy Dog
I prefer a dog that. . (Check all that apply)
Loves children and strangers Can tolerate children and strangers Loves all other animals.
Can tolerate all other animals Don t care if he/she gets along well with other animals
When it comes to relating to dogs, I tend to be more:
Strict, demanding (the dog must sit for a cookie)
Moderate, (encourage good behavior, ignoring bad)
Lenient, a little wishy-washy, easily coerced by the dog (the dog looks cute, so it gets the cookie even
without performing the sit.)
Someone in my home is nervous or unsure of dogs.
Very (e.g. bitten as a child) Moderately Some (no experience with dogs) N/A
The noise/activity level in my home is usually: High Medium Low
Continued on Page 3
Dog Adoption Application — Page 3
Applicant Name:
I would enjoy brushing or grooming my dog:
Rarely Occasionally Daily Weekly Monthly
I would prefer a dog that:
Would enjoy walking with me on leash Would enjoy going to a dog park
Would run, jog, or hike with me Will exercise itself in our yard
Requires only enough exercise to do its business
I need a dog who will tolerate being alone Hours per day
My ideal dog would:
Dog habits that I just can t tolerate are:
I certify that the information shown above is true and correct to the best of my knowledge. I also acknowledge that
falsification of any of the responses can result in my being denied adoption of an animal or, if an animal has been
released for adoption to me, the return of that animal to N.E.W Animal Protection League.
Signed Date
Case Reviewed by Date
Number
