Adopt a Pup We Release from our Program

Name of person completing this form:

Why do you want to adopt a dog now?*

A Dog will cost you approximately $1,500/yr to care for - food, supplies, vet care, grooming, etc. Can you afford this?*

YesNo

What need(s) do you hope a dog will fulfill in your household?*

Who currently lives in your house? Please list name and age of all people.*

What other animals do you currently live with? Please indicate breed, neutered/spade, age.*

If you have other animals, how do they react to dogs? Have they ever growled, snapped resource guarded, cowered, avoided people and other dogs?*

What type of setting do you live in? Near busy street(s)?*

How many hours/day will the dog be left alone?*

0-33-66-9

Where will the dog be kept when it is alone?*

Do you have a fenced yard? If yes, what type of fence, and how high?*

YesNo

If you don’t have a fenced yard, how will the dog be exercised? (Please be specific)*

Who will assume responsibility for caring for the dog/taking it out 4+ times/day to eliminate?
Exercising it (a minimum of a 20 minute walk every day, running 5-10 minutes in a fenced
area)?*

How many other dogs have you owned? Please list breed/age/ and what happened to them.*

How much obedience training have you had? What methods of training a dog were taught to
you?*

Please give us 2 references that will attest to your ability to competently and humanely care for a dog. (Include phone numbers please).*

Reference #1:

Reference #2:

Anything else you’d like us to know?*