| Name of dog (from the Petfinder adoption list) or breed/characteristics that you want: |
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| First and Last Name: |
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| Email Address: |
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| Street Address: |
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| Daytime Telephone: |
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| Evening Telephone: |
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| Employer: |
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| Type of dwelling (Apartment, single family residence, duplex, townhome, condo, loft, etc?) |
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Do you have a fenced yard? Yes
No
(Please note that we require a fenced yard for certain breeds or for those dogs in our program who are known to be “runners”.) |
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| If no, where will the dog exercise, play, take potty breaks, spend time alone? (Type N/A if not applicable.) |
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| Do both adults work outside the home? Yes
No
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| Number of adults in the home: |
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| Number of children in the home and ages: |
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| Approximately how many hours per day would your dog be home alone? |
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| Do you currently have other dogs or cats? Yes
No
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| If yes, please give names, breeds and ages, as well as any other relevant information about the pet: (Type N/A if not applicable.) |
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| If you have current pets, are they spayed/neutered? Yes
No
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| if no, please explain as it is a requirement for approved adoption applications: (Type N/A if not applicable.) |
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If you don’t currently own a pet, have you owned one in the past?
Yes
No
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If yes, please explain why the pet is no longer with you:
(Type N/A if not applicable.) |
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| Name/address/phone # for current veterinarian (To check current pet records.) or veterinarian that you plan to use (if you don’t have a current pet.) |
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| Where will your pet stay during the day? |
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| Where will your pet stay at night? |
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