Animal Application

by k-, July 21, 2020

Dog Application

Animal Info

Animal Name:

Animal ID #:

Applicant Info

Applicant's First Name:

Middle Name:

Last Name:

Age:

Drivers License #:

Phone #:

Email Address:

Address:

City:

State:

Zip Code:

County:

Co-Applicant Info

Co-Applicant's First Name:

Middle Name:

Last Name:

Age:

Drivers License #:

Phone #:

Email Address:

Homeowner Info

Do you:
Own
Rent
Live with relative

Applicant Home

Could you be moving/being deployed soon?
Yes No

If you had to move/be deployed, what would you do with the animal?

Are you currently employed?
Yes No

How many other adults and children live in the home?

Please list their name, age, and contact numbers below:

Does anyone in the home suffer allergies related to animals?
Yes No

By your best estimate, how much money do you anticipate to spend on a pet each year (vet care, food, toys, etc) $

Dog Care

How many hours per day would the animal be left alone on a normal day?

Who will be the animals primary caregiver?

Are you familiar with the breed and behavior of this dog?
Yes No

Please explain your housebreaking plan:

Do you have a fully fenced yard?
Yes No

Please describe your pet ownership experience (Include past AND current pet names, breeds, spayed/neutered, when owned, etc.):

Which veterinary hospital did your previous pets attend?

What persons name would the vet records be under?

Are your current pets up-to-date on vaccines and preventative medications?
Yes No

Where will the dog be kept during the day?

Where will the dog be kept at night?

What would you consider a valid reason to give up/return this animal?

Have you ever surrendered to a shelter or re-homed an animal before?
Yes No

	Scheduled Adoption Appointments	Give-ups / Other Business
Monday	11:00 to 3:30	11:00 to 3:30
Tuesday	11:00 to 3:30	11:00 to 3:30
Wednesday	11:00 to 3:30	11:00 to 3:30
Thursday	11:00 to 3:30	11:00 to 3:30
Friday	11:00 to 3:30	11:00 to 3:30
Saturday	11:00 to 3:30	11:00 to 3:30
Sunday	11:00 to 3:30	11:00 to 3:30

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