Adoption Application


Please cut/paste the information below into an email, answering all questions and then email it to kmnoe24@yahoo.com. If you are not familiar with doing a cut/paste just answer the questions, numbering them accordingly. We'll then match your answers with the application questions. Thanks!

Your Name:
Your Address:
Your City:
Your State:
Your ZIP Code:
Your E-Mail:
Please Enter Your Email Address Again:
Home Phone:
Work Phone:

1. A home inspection is required before the adoption process can be finalized. Do you agree to allow us to do a home inspection? (Yes or No)

2. What is your age category?
Under 18
18-25
26-30
31-60
Over 60

3. Why do you want to adopt a dog?

4. Are you adopting this dog for yourself or as a gift for another person? If the dog is to be a gift, what is your relationship with this person?

5. Do you currently own any other pets? If so, what kind?

6. Are any cats and dogs that you currently own up to date on their vaccinations and properly licensed with the county?  

7. Are any cats and dogs that you currently own spayed/neutered? If they are not spayed or neutered, why not?

8. What type of heartworm preventative do you use for any cats and dogs that you currently own?

9. Where do cats and dogs that you currently own primarily stay?

10. Have you owned any other cats or dogs in the last five years that you no longer own? If so, what happened to them?

11. What is the name and phone number of the veterinary hospital at which your animal(s) has/have received care and vaccinations?

12. How many people currently reside in your household?

13. What are the ages of any children living in the household?

14. What are the ages of any children which frequently VISIT the household?

15. Who will be responsible for feeding the dog and taking it outside?

16. Please describe your dwelling. Is it a home, an apartment, a condominium, a town home, a mobile home, other? If other is your reply, what type of dwelling do you have?

17. Do you own or do you rent?  

18. If you rent, what is the name and telephone number of your landlord?

19. Do you have a fenced yard? If so, what type of fence is it? How high is it?

20. How much time will this dog spend outdoors during a normal 24 hour period?

21. How many hours will this dog be left alone during a normal 24 hour period?

22. When you are home, where will the dog be kept? (outside, crated, loose, confined in a single room, etc)

23. When no one is home, where will the dog be kept? (outside, crated, loose, confined in a single room, etc)

24. Where will the dog sleep at night?

25. If we do not currently have the type of dog you wish to adopt, please tell us below what you are looking for (breed, size, age, sex, housebroken, etc).


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