First Name*
Last Name*
Address
City
State/Province
Zip/Postal Code -
Email*
Cell Phone
Which animal are you interested in Choose an animal: Cats Dexter-Sponsor Eva Foxy Reggie Sienna Silk
Please list the names and ages of everyone in the household (include yourself)
Does any member of your household have dog allergies?
Are you committed to taking full responsibility for your adopted pet's health and welfare for the rest of it's life, which could be 15 years or more?
Are you financially prepared to handle a medical emergency if necessary?
List two references and their contact information (one who is not a family member)
What traits are you looking for in your new dog?
Why are you interested in adopting at this time?
How much time will the animal spend alone during the day
How much training are you willing to do? Describe how you will train your new dog.
Under what circumstances would you give up your pet? (check all that apply)
Have you ever given up a pet? If yes, please explain
In what type of home do you live? Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
Do you own or rent your home? Choose one: Rent Own
If you rent, please enter your landlord's name and phone number
Is your yard fenced? Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced
What is the height of the fence?
When do you feel it is ok for dogs to be off leash outside of the home? (check all that apply)
List all animals currently living in your home. Provide name, type/breed, age, sex, if spayed/neutered and how long you have owned.
List all Veterinarians you have used and their contact information (if the pet is listed under a different name than the one on your application please provide that name)
How did you hear about us?
Would you like to be added to our email list for news and updates?
Would you like to receive pet nutrition/wellness information and specials? Any purchase helps raise money for our animals!
I understand the adoption fee is $450 unless otherwise discussed. Fees may be higher or lower depending upon each pet's situation. We do not receive any funding and rely on adoption fees to be able to continue the work that we do.
I understand that the adoption fee is non-refundable
I understand that a home visit may be required. Is this acceptable to you?
Comments/Any other information you would like to provide?
