Dog Adoption Application

APPLICANT INFORMATION
Pet's Name:		Pet's Reference#:

First Name:		Last Name:
E-mail:
Address:
City, State, Zip:
Day Phone:		Evening Phone:	Cell Phone:
Driver's License# & State:

Are you 18 years old or older? Yes No
Have you ever owned a dog before? Yes No
Do you live in a home condo or apartment? Do you own or rent your home?

Do you have written permission from your landlord to own a pet? Yes No

If renting, landlord's name and phone:
How long have you lived at this address?:		Do you have plans to move?:

FAMILY/HOUSEHOLD INFORMATION
Are there children in the household? Yes No		What are their ages?
Have the children had pets before? Yes No
Is anyone in the household allergic to dogs? Yes No
Do you expect your current family situation to change?: Yes No
Are all family members in agreement about this adoption? Yes No
Why are you considering adopting a dog from SARF?
Companion for self	Companion for child	Companion for another household member	Watchdog	Gift

Name	Breed	Age	Gender	Altered?	Where are they?
PET INFORMATION
Have you had pets in the past or do you currently have pets? Please tell us about them
			M F	Y N
			M F	Y N
			M F	Y N

Have you ever given an animal away or relinquished an animal to a shelter? Yes No
If yes, what were the circumstances?
VETERINARIAN INFORMATION
Veterinarian's name and phone:
When was your current pet's last visit to a veterinarian and why?:
May we contact your vet as reference? Yes No

NEW PET INFORMATION
What will you feed your new dog?:	How often will you feed it?
How much time are you prepared to allow for your new dog to adjust to your home?:
Are you able to afford a bill of $200-$500 (or more) for emergency veterinary care? Yes No
Are you, and those who live with you, committed to spend 12+ years providing health care, food, grooming, training and attention for your dog? Yes No
If you have to move, what do you plan to do with your pet(s)?
Who in the household will be the dog's primary care giver?
This dog will be inside only outside only both
Do you have a fenced yard? Yes No If Yes, what type of fencing and how high? If No, how do you plan to contain the dog?
Do you own a pickup truck? Yes No If yes, where will the dog ride? How will you restrain your dog if riding in the back of a truck? Do you or your neighbors own livestock, farm or exotic animals? Yes No If this dog is not housebroken, how are you going to train your new dog? If behavior problems do present themselves at a later date, will you be committed to working with the animal to correct these and most other problems? Yes No If no, what alternatives to you have? Where will your dog be during the day? At night? How many hours each day will the dog be unattended? What will you do with your dog while you are away on vacation?
What problems would make you return a dog? (check all that apply)

Barking	Housebreaking	Digging	Not getting along with other pets
Chewing	Shyness/fear	Climbing on furniture / jumping up
Other (explain)
Are you aware that a SARF representative will visit your home before adopting the dog and/or after the adoption, if considered necessary? Yes No
Comments:
The adopter must NOT chain the dog under any circumstances. By clicking "Submit" I certify that the information I have given is true. I understand the SARF reserves the right to deny my application for any reason. I further authorize the investigation of all statements in this application.