ADOPTION APPLICATION

Dog you are interested in________________________________________________

 1.    Are you 21 years or older?  YES/NO

 2.    Your full name____________________________________________________

        Address________________________________________________________

        City, State Zip____________________________________________________

        Home Phone__________________________ Cell________________________

        Work ________________________________

 3.    How long have you lived at the above address?____________________________

 4.    Are you planning to move in the next 6 months?  YES/NO

 5.    Do you Rent/Own/Live with relatives/Live with a roommate?  Circle One

 6.    If you rent, does your landlord/roommate allow pets?  YES/NO

 7.    Name and phone number of landlord or relatives/roommate that you live with:

        ________________________________________________________________

 8.        Where will the animal stay when you are not home? Loose inside__________,

        Crated or otherwise restrained inside_______________, Loose outside _________________

        Kennel run _______________, Fenced Yard _____________, Tied/chained outside _________________,

        Other (describe)________________________________________

 9.          If you have a fence, type? Chain link/ Wooden / Barbed wire / Wrought Iron?

10.    If you have a fence, how high is it? 3ft  4 ft  5 ft   6 ft  8 ft

11.         Is the pet for your family? YES/NO if not, is it a gift? YES/NO

12.         How many people live in the adopting household? ____________________________

         Do they all know you are adopting this animal? YES/NO

13.        Do you have children? YES/NO  If so, what are their ages? _______________________

14.        If not, do children visit the home often? YES/NO ages? _________________________

15.         Do you own other dogs or cats? YES/NO

16.          If yes, please describe breed, sex, and age of each:

BREED                                   SIZE       AGE         SEX         Spayed/neutered

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

      If not altered, why not? ________________________________________________

 18    Are they current on yearly vaccinations? YES/NO

 19    Are they currently on heartworm prevention? YES/NO What type? _______________

       20    Does your city, subdivision, landlord have any restrictions on the number of pets you can own? YES/NO

             If so, what is the limit?___________________________

 21    How many cats or dogs have you owned in the last 7 years?

 Dogs _______________ Cats _____________ What happened to them?

  ________________________________________________________________

       22 Your Veterinarian’s name and phone # ____________________________________

            Do you give permission for me to contact? Yes/NO  Initials ____________________ 

 23  How many hours a day will the animal spend alone? __________________________

Where will it stay when it is alone? _______________________________________

Where will it stay during the day? ________________________________________

Where will it stay at night? _____________________________________________

24 What problems would make you return the animal? Barking / housetraining/ chewing/jumping/

     shyness/ digging/shedding/ other-explain:

___________________________________________________________________

25    To help resolve these problems, are you willing to: Use a crate / Take an obedience

Class / Do nothing

26    Check the traits that are most important to you in a pet:

______Good with Children    _________Low energy _______ High energy

______ Good with dogs _____ Good with cats _________ Travel well

______ Coat length _______ Won’t need obedience training

______ doesn’t chew, dig, jump _______ will run with jogger owner

______ Appearance 

      27    Under what other possible circumstances would you return the animal:

Move / New Baby / Divorce / High cost of animal care / Personal illness / Other:

Explain __________________________________________________________

________________________________________________________________

      28 Are you willing to sign a legally binding Contract that promises that you will return    

            the animal to Dondi Prestwood if at anytime during it’s life, you find yourself unable  to care for it?

            YES/NO

I represent that the above information I provided on this form is the truth to the best of my knowledge and belief.

Any falsification or omission of any question of any of the above information will result in automatic refusal of adoption or 

confiscation of the adopted animal.  Dondi Prestwood has the right to deny the adoption of any pet for any reason.

My objective is to assure the safety and welfare of the pet.

APPLICANT: __________________________________________ DATE ______________