Adoption Application Form

Basic Information:

Your First Name:     Last Name:
Which dog(s) are you interested in?:
Phone #:
Place of Employment:
Your Age (and the ages of members of your household):


Why do you want to adopt now?

What do you think are the most important responsibilities in owning a dog?

Please list preferences (age, sex, breed, personality):

Have you submitted an application to another organization for a dog at this time?
Yes No

How will you housetrain the dog (untrained adult or puppy) and how long will you try:

If adopting a puppy are you prepared for razor sharp teeth and the "natural" chewing stage?

Does any member of your household have allergies to animals? Explain:

Describe the kinds of personal situations where you might have to return/rehome your adopted dog, i.e. job loss, children, move, marital change, etc.:

For whom are you adopting the dog?

How many people live in your home?

Are there children in the household?
Yes No

What type of diet are you planning to provide your dog? Brand, etc.

Who will care for the dog should the primary caretaker become incapable of owning this dog?

Will you take obedience training?

Will you be willing to obtain the appropriately sized, open wire crate, if recommended?

Describe the pets you currently own:
Primarily indoor or outdoor?
How did you aquire pet(s)?

Describe all pets you have previously owned in the last 10 years:
Primarily Indoor/Outdoor?:
How did you part with pet?:
Year deceased:
Cause of death:

Name of veterinarian who will provide for your pup's health care:

If a behavioral problem arises, what steps will you take to work it out?

You are rescuing a dog from a humane pet shop. We are reliant on merchandise sales to continue to rescue and care for our dogs. To adopt a bark n' bitches rescue dog you are required to spend a minimum of $175 in supplies on your new pet. We offer 20% off all merchandise today (excluding food) plus a 10% lifetime discount. What supplies do you need today?

A rescued animal will have a period of adjustment when entering into your home. This period may be a few days to several months and could result in temporary behavioral changes. How will you assist your pet through this transition?

Do you understand that you will be sharing your life with a dog for 14-18 years, and that this dog will be totally dependent on you for food, exercize, shelter, health and veternary care?

Are you willing and able to make a life-long commitment to a dog as a family member?

What type of home do you live in?

Do you rent or own?
Rent Own
If you rent, landlord's:

Do you have a fenced yard? Please describe:
      Any holes or gaps?
      Are you in an area with coyotes?
      Yes       No

Describe the circumstances where you would walk your dog off-leash:

Describe the daily exercize/socialization routine:

How many hours will the dog be left unattended while you are at work/school/ect.?

Where will the dog sleep?

Where will the dog be kept when you are not home (running erands, etc.)?

How often do you travel?

What will you do with the dog while you are out of town?

If you move what will you do with the dog?

Are you aware of the non-refundable adoption fee of between $395 and $695?
Yes No

Additional Comments: