Application for pet
This application is not a approve or deny application but more of an information collecting item. Please be thorough and fill out all parts of form. Thank you and we hope to place you with a dog soon!!
Full Name*
Phone Number*
Address(complete with city and state) *
Email*
Age of potential foster?*
Date of Birth
Do you rent or own your current residence? *
Rent
Own
What type of residence do you live in?*
Landlord Name (if applicable)
Landlord phone number (if applicable)
Do you have plans to move in the near future?*
Yes
No
If yes, please provide explanation.
What is your primary mode of transportation?*
Number of adults in the house and their relationship to you.*
Number of children in the house *
Have all members of the household agreed to obtaining a dog?*
Yes
No
Do you currently have another pet in the house?*
Yes
No
If you don't currently own a pet, please provide the name and phone # of the vet you wish to use for a new pet. *
Current Pet #1- Name, Age, and Breed
Have you had pets previously?*
Yes
No
How long did you have this pet?*
Why do you no longer have this pet?*
Have you ever been issued a citation or had to reclaim your pet from animal control or the shelter?*
Yes
No
Have you ever given up a pet?*
Yes
No
Veterinarian dog will be going to?*
Veterinarian phone number:*
Veterinarian address:*
In case of emergency do you have a 24/7 pet hospital? *
YES
NO
24/7 Pet hospital phone number:
24/7 Pet hospital address:*
What amount of time will your dog be left alone?*
When you are NOT home, where will your dog be kept?*
When you ARE home, where will your dog be kept?*
Do you plan to crate the dog?*
If yes, please explain when the dog will be crated. If no, please describe in detail where the dog will be when you are not around.*
How much time would you allow your dog outside unattended?*
Do you have a fenced in yard?*
Yes
No
Under what circumstances would you give up a pet?*
Are you prepared for a potential 1-2 year commitment?*
Yes
No
Can you afford vet costs that come with owning a pet. Emergency costs?*
Yes
No
Personal reference #1 *
Personal Reference #2 *