Adoption Application

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Home
- Our Start
- Photo Gallery
Adoptable Dogs
- Pet Finder
Adoption Process
Meet Us!
How You Can Help
Contact Us
- Find us on Facebook
Pet Resources

Home
- Our Start
- Photo Gallery
Adoptable Dogs
- Pet Finder
Adoption Process
Meet Us!
How You Can Help
Contact Us
- Find us on Facebook
Pet Resources

Chihuahua you are applying for

Name *

Address *

Email Address *

Home Phone *

Cell Phone

Work Phone

Are you over 21 yrs of age *

YesNo

Occupation

Marital Status

Spouse's Name

Is Spouse over 21 yrs of age *

YesNo

Spouse's Occupation

How long have you lived at this address

Ownership

OwnRentOther

Type of Residence

Single Family HomeApartmentTownhouseMobile HomeAcreage

Setting

RuralSuburbanUrban

Do you have a fenced back yard

YesNo

Type of Fence

PrivacyChainlinkOther

Condition of Fence

NewGoodNeeds Repair

If Renting, are dogs allowed

YesNo

Landlord's Name, Address, Phone

Name, Age, Relationship of any other adults living in the home

Name, Age, and Relationship of any children living in or frequently visiting the home

Are you planing on having any children in the future

YesNoMaybe

List the Name, Type or Breed, Gender of any dogs living in the home, and how long you have had them

List any other dogs owned within the last 10 yrs, and why you no longer have them (ie stolen, died, gave away, etc.)

Describe an average weekday in your home

What will your newly adopted pet's living situation be like when you are not home

Loose indoorsConfined to one roomCrated indoorsKenneled outdoorsLoose in fenced areaTied/Chained outdoors

How will you exercise your dog

Leash WalksOutdoor Kennel/RunFree run of fenced yardOther

What do you consider reasonable routine vet expenses per year

under 50100-300300-500over 500

Primary Veterinarian, Address, Phone

Secondary Veterinarian, Address, Phone

Are your current pets on heartworm preventative

YesNo

Are your pets current on vaccines

YesNo

Are your pets spayed or neutered

YesNoSome

What temperament in an adopted dog will best suit your personality or lifestyle

List Name, Phone, and Relationship of Three Friends or Relatives

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