Which dog are you interested in?
(we know them by name not number)




Personal Information:

Name: 
Address: 

Street  

City     State 
Zip 
What County: 
 Home Phone:
 Cell:
 Alt:

Email:

Age


 Do you rent or own your home?

 If you rent, we will need to contact your landlord to verify that you are 
allowed to have a pet on the premises. 

Landlord Name:  Phone:

Questionaire:

Have you ever given up an animal? 
If yes, why and where did you take it? 
Have you ever been issued a citation for your pet or had to reclaim your pet from animal control/shelter? 
If yes please explain. 
Are there children in the home? 
If so, what are their ages? 

List any previous and current pets in your home
 including their sex, age, current health condition or cause of death and if they were/are 
spayed or neutered. Please give number and name of place that spay/neutered pet for verification. 



Will your new pet be kept inside, outside, or inside/outside or strictly outside? 

Where will the pet stay during the day? 
Where will the pet stay during the night? 
Do you have a fenced in yard?  
If yes, what type and size?  
How many steps do you have to get out to your yard?
How do you plan to housebreak the dog?

If you have to move, what would you do with your adopted pet? 
What circumstance would you have to surrender your pet? Divorce? New baby? allergies? aggression? housebreaking issues?
 
 Are you ready for a possible 20 year commitment?

 Have you ever taken a dog through obedience class? Do you plan to take this one? 
 


Can you financially afford the Veterinarian costs for your new pet? Emergency Costs?
Your current Vet and phone number: 
Please list at least 2 references:  


Other Information or comments:  


We accept cash or check only for adoption fees. 
Thank you. 
If your application is approved we will notify you 
by email on a date and time to come meet the pet.