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If you are interested in adopting one of our pets, please fill out the below form. We would like information about you, your past pets, and your current pet preferences.


Don’t forget to call your Veterinarian to give us permission to do a Vet reference check.

Thank you for adopting from us!

Name (First, Last):
Co-Applicant Name (First, Last)
Street Address
State and Zip Code
Mailing Address (if different)
Home Phone
Cell Phone
Work Phone
E-Mail Address
Age Desired
Is there a specific dog you are interested in? Please name, specify color, and gender.
Why are you interested in this dog?
Would you consider a special/needs dog - one who requires medication?
Will you accept a mixed breed?
Please choose the activity level of your ideal dog.
Preferred Sex:
Ages of ALL Family Members
Do they or other family members live or visit you often?
Do they share you interest in adopting a dog?
Who is the dog primarily for?
Who will care for, train, and exercise the dog?
Does anyone in your household have allergies?
If yes to what?
May we visit your home prior to application approval?
If yes, when is best?
Please list all the most recent pets you have owned in the past: (species, sex, name, and status
Please provide the full name, City, State, and phone number (very important) of your current vet
Please identify any other veterinarians that you have used most recently, if different from above.
How long have you lived at your current address?
Do you own or rent?
Renters: Must provide Landlord's name/phone:
Do you have the permission of your landlord to have a dog?
If so up to what size?
How long daily will the dog be left alone (without humans)?
Where will the dog stay when you are away from the house?
Are you familiar with the use of a dog crate to train the pet during your absence or at night?
Is your yard fenced?
Type of fence? (include Height, Width, and Length)
If you do not have a fence, will you install one?
Approximate size of dog's yard area
Will the dog be walked daily and/or exercised in a fenced yard?
Ever allowed to run free without supervision?
Will your dog receive formal obedience training?
Have you ever had a dog before?
Are you aware that routine costs average $500/dog/year?
Have you ever sold, given away, or surrendered a pet to a shelter? If yes, please specify reasons.
Please tell us why you want a dog:
Please tell us a little of your lifestyle, your family, and activites the dog will be involved in.
When you move what will you do with your dog?
Do you understand the state and local ordinances concerning licensing and leashing?
Have you, or any household members been cited for leash law violations or cruelty to animals? Please
When you go on vacation who will care for your dog and where will it be care for?
I/we attest that the information provided on this application is true and accurate to the best of my
I/we understand that completion and submission of this application does not guarantee adoption of a
Please sign your name and today's date.
Co-Applicant's name and today's date.