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Adoption Form
Your Personal Information
FIRST NAME
LAST NAME
CELL PHONE
EMAIL ADDRESS
Date of Birth
CURRENT ADDRESS
CITY
STATE
California
ZIP CODE
BY CHECKING THIS BOX I AM CONFIRMING THAT I AM 18 YEARS OF AGE OR OLDER.
Select up to 3 pets you are interested in adopting
1st pet choice
2nd pet choice
3rd pet choice
Occupation
OCCUPATION:
EMPLOYER:
Home Details
HOUSING TYPE:
HOUSE
APARTMENT
CONDO
TOWNHOUSE
DO YOU RENT OR OWN?
RENT
OWN
if rental, please provide landlord's name and phone number
if rental, are animals permitted? (we will require a letter or email from your landlord attesting to the pet policy of your residence)
YES
NO
Adults in Home (Please list number of adults and ages in your home)
Children in home (Please list number of children and ages in the home)
why do you want to bring a new dog into your home?
is everyone in the household in agreement on adopting a new dog?
how long have you resided at your present address?
are you planning to change residence in the near future? (if yes, please explain)
Do you have a yard?
YES
NO
if yes, is it fenced?
YES
NO
if yes, please provide the height of your fence and the material of the fence (wood, chain, etc)
Why did you choose this particular dog or dogs?
what is your typical schedule each week?
how much daily exercise will you provide? (explain)
how long will your dog be left alone during the day?
Where will your new dog be kept while alone?
will you be crating your new dog?
YES
NO
have you ever crate trained a dog?
YES
NO
Do you understand that your new dog may develop some issues as it adjusts to its new home?
Will you tolerate the following during that adjustment period?
House Breaking Accidents?
YES
NO
Chewing?
YES
NO
Barking/Whining?
YES
NO
If no, to any of the adjustment behaviors listed please explain why.
what do you consider a reasonable amount of time for your dog to adjust?
if these issues don't get resolved in a reasonable amount of time, what will you do?
Does anyone in your household have known allergies to dogs?
YES
NO
Do you have animals now?
YES
NO
What kind? (list species, breed, age, sex)
are they spayed/neutered? (if no, please explain)
are there any circumstances you can think of that would cause you to give up a pet in the future? please explain in as much detail as possible.
By submitting this application you assure that all is true and accurate.
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