Adoption Application 1 Personal Information2 Animal Information3 Household Information Personal InformationPlease fill in all fields. All items are required for your application to be considered.Name* First Last Application Date* Date Format: MM slash DD slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Animal InformationPlease fill in all fields for the dog or cat you are interested in.What type of animal?*DogCatName of animal you are interested in:*Why are you choosing this animal?* Household InformationPlease fill in all relevant fields. All required items are needed for your application to be considered.Age and gender of all persons in home:*Who will be primarily responsible for taking care of the animal?*If you currently have animals, what types and ages are they?Are your current animals spayed or neutered?If you have animals, what type of heartworm and flea preventative are you currently using?Describe where the animal will live:*If adopting a dog, where will the dog sleep at night?If adopting a dog, where will the dog be when alone during the day?Tell us about all prior animals you have owned (types, when & where you got them, how long you had them, indoor/outdoor, what happened to them):*Do you rent or own?*RentOwnIf renting, please provide rental agency name:Rental Agency Phone NumberDo you have a fenced in yard? If so, what type and how tall?*How long will the animal be alone during the day?*Vet's Name (for references)*Vet's Phone Number*Have you ever had to give an animal away? If so, why and to whom?*Are you prepared to make a financial and emotional commitment to love and care for this animal for the rest of its life however long that may be and however aggravating the animal may be at times?*YesNoWould you consider professional dog training for your new dog if challenges arise?YesNoCommentsThis field is for validation purposes and should be left unchanged.
