Are you applying to adopt a specific dog? If so, who?
If you are not applying to adopt a specific dog, what kind of dog are you looking for? Color? Age? Breed? Other?
If Other, please explain.
Phone *
Email *
Job Description and Place of work:
If you rent, do you have consent from your landlord to have a dog?
If “Other,” please explain.
How many people live in your home? How many adults? How many children? If children live in the home, what are their ages?
If no children live in your home, are children frequent visitors to your home? If so, please specify their ages:
Does anyone have any known allergies to dogs?
Do you have any pets now? How many? What kind?
How long have you had these pets? Give number of years individually:
If above you mentioned that you have dogs as pets, please provide their age and type of breed:
If you do not own pets currently, have you owned pets previously?
If so, what kind? Please also provide the information requested above regarding these pets. What happened to these pets? *
Have you ever given a pet away? If so, to whom and for what reason? *
What do you consider a justifiable reason for giving a pet away? *
If a dog who is placed in your care should bite after going home, what measures will you take? For example, would such an incident prompt you to return the dog immediately? To consult a behaviorist? To take the dog in for a medical check? *
Who will be responsible for the care of this pet?
Where will the pet be kept during the day? During the night?
If you work outside the home, what arrangements will you be making to have the dog walked during your work day?
Please provide a name and telephone number as a veterinary reference. If you have never owned a pet, please provide a personal reference's name and EMAIL ADDRESS instead. Many vets will not speak to us without your permission. Please make sure you call your vet to let them know that we will be calling and grant them authorization to speak with us. PLEASE NOTE: Applications without either a vet or personal reference will NOT be considered.
Have you ever submitted an application to another rescue that was refused? If so, what reasons were given?
Digital Signature *