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First Name *
Last Name *
Home Address *
City *
State *
Zip Code *
Age *
Your Occupation *
Phone Number *
Email Address *
What dog are you interested in adopting? Please include the name of the dog. *
Name of spouse/significant other? *
Significant other/spouse's occupation? *
Do you have any children? If yes, please list age *
Do you have any roommates? If yes, please list name and age *
Is everyone in the household aware you are interested in adopting a dog? *
Does anyone have pet allergies in your home? *
Who will be responsible for the dog? *
Are you aware dog can live 15-20 years and are willing to take on this responsibility? *
Why do you want to adopt a dog? *
Please describe the type of dog you’re hoping to adopt — including any preferred breed, age, size, coat type, energy level, personality traits, or any other qualities that are important to you. *
Is this dog a gift? If yes, please explain *
What type of home do you live in? * Single family home Townhome Apartment Condo
Do you rent or own your home? * Rent Own
How long have you lived at this address? *
Do you have plans of moving in the future? * Yes No
If you rent, are dogs allowed? * Yes No N/A
If you rent, please list the name and contact information of your landlord *
In what areas of your home will your dog be allowed? *
When you are not home, where will the dog be kept? *
Do you have a yard? * Yes No
What type of fence? *
How tall is your fence? *
Does the fence fully enclose the yard? * Yes No
If you do not have a fenced yard, how will your dog be let out? *
Do you have a pool? * Yes No
If you have a pool, will dog be left unattended around the pool? Yes No
If you have a pool, what will you do to ensure the dog’s safety? *
Do you have any toxic plants inside or in the yard? *
How many hours per day will the dog be left alone? Please include typical days and approximate times. *
Is this your first pet? * Yes No
Where will your dog sleep? *
What type of lifestyle do you have? * Sedentary Moderately active Very active
What activities will you do with your dog? *
Are you familiar with the breed you are interested in adopting? *
Do you currently have any pets? If so, please list name, breed, and age of all pets *
Do your current pets live indoor, outdoor, or both? Please list each pet *
Are your pets current on their vaccinations? * Yes No N/A
Are your current current pets fixed? * Yes No N/A
Will you keep your dog up-to-date on vaccines? * Yes No
Have you had pets in the past? If so, please list name, breed, age and why you no longer have them *
If applying for a puppy, have you raised a puppy before?
Were you ever in a situation you could not keep your pet? If so, please explain *
In the event you are no longer able to care for your dog, who will be responsible for their care? Please include name and relationship *
What kind of food will you feed your dog? Please include brand *
What precautions will you take when introducing the new dog to your current pets? *
Are you okay with a home check * Yes No
If a disciplinary or behavioral problem arises, what will you do? *
Are you willing to give your new pup proper time to adjust in your home after adopting? Rule of thumb is: 3 days to decompress, 3 weeks to learn your routine, 3 months to feel themselves. *
Do you have any preexisting commitments that would prevent you from adopting the dog you are applying for as soon as he/she becomes available? In some cases, that could be as soon as the next day. Examples: Vacations, surgeries, dog sitting, family visiting, remodeling of home, moving, etc. *
If the specific dog you applied for has already been adopted or has a meet-and-greet scheduled, would you like us to contact you about other available dogs that may be a good fit for your home? Yes No
We are a volunteer, foster-based rescue. Our team members all work full-time jobs and do this out of a deep love for animals. Do you understand that we may not be able to respond to every application, and that we typically contact applicants who are the best fit for the animal within 72 hours of submission? *
Is there anything else you would like us to know?
How did you hear about us? *