Puppy/Dog Adoption Application

PLEASE NOTE - - YOU MUST BE HEAD OF HOUSEHOLD TO ADOPT FROM US

PLEASE FILL OUT THE ENTIRE APPLICATION - FAILURE TO ANSWER ALL QUESTIONS CAN RESULT IN YOUR APPLICATION BEING DECLINED. THANK YOU!

Date *

Name of Requested Pet:

2nd choice if Requested Pet is not available:

Our Adoption Fees: *

Puppies to 6 months – start at $550 plus $125 deposit if unaltered

Puppies 6-12 months – $500

Young dogs 1-5 years - $350-$450

Dogs 6+ years - $200-$300

**All puppies too young to be altered will require a $125 deposit which is refunded when spayed or neutered.

Please indicate what size dog you are looking for or prefer (when fully grown): *

Do you currently have other pets at home? *

Yes

No

If you answered yes, please indicate which pets live with you:

Name *

Address *

Town *

State *

Zip/Postal Code *

Phone Number: *

Email Address *

Are you Head of Household? *

Yes

No

Are you a student and/or do you live with roommates? *

Yes

No

Please indicate your age range. *

How did you find the pet you are interested in? *

What is your primary reason for wanting a new pet? Check all that apply: *

When are you ready to adopt? *

I am ready to adopt now.

Within 2-3 weeks

I would like to be preapproved for the future.

Are you interested in our ADOPT AT HOME option? See Adoption Process for more info. Adopt at Home

Yes

No

Do you currently have an application pending approval for another puppy/dog (not with us)?

Yes

No

Are you interested in FOSTER to ADOPT? This option is not for puppies.

Yes

No

Are you interested in adopting a dog/puppy only because your children want one?

Yes

No

1. How many members (people) are under the age of 18 yrs. in your household?

2. Please state their ages:

3. Is this your first pet (not a family pet that you grew up with) or has your last pet been deceased longer than 10 years?

Yes

No

4. If you answered Yes, please provide 2 references. One may be a family member. You can skip to Question No. 8.

Name:

Relationship to You:

Phone Number - we text only.

Name:

Relationship to You:

Phone Number - we text only.

Small (1-25 lbs)	Medium (26-60 lbs.)	Large (61-100 lbs.)
Extra Large (101 lbs. or more)	It's not important.

Young Dog(s) up to 1 year	Dog(s) 1-5 years old	Dog(s) 6 years or older
Cat(s)	Other

21-30 years old	31-45 years old	46-55 years old
56-65 years old	66-75 years old	76 years and older

Companion for me	Companion for children	Companion for other pet
Watch Dog	Gift	Rescue a Homeless Pet