Please list the name of the dog(s) you are most interested in:
Please state your DOB and Age:
What is the occupation(S) of the applicant:
Please Provide three (3) Personal (not related to you) references including and phone numbers for each reference.
Do any children live with you or visit frequently? If so, Please state age of each child.
In what type of home do you reside-i.e., single-family, apartment, condo, ect.? If rent, please provide name and phone number of your landlord.
Please list all persons who live in your home and state the relationship of each person to you.
Do you have a yard? Is it fenced? If so, state what type (chain link, privacy, ect.)
Who will be the primary caretaker of this dog?
On average, How many hours per day and days per week will the dog be left alone in your home?
How do you plan to exercise the dog-e.g., on-lead, free in fenced yard, etc.?
Where will the dog spend the day and the night? Please state briefly where the dog will be kept when nobody's at home, when someone is at home, when everyone is sleeping, ect.
Does your homeowners insurance prohibit you from adopting the breed in which you are applying for?
Do you have any pets of any kind at this time? If so, list each pet (including name, breed, age, etc.) and state whether any or all of them are neutered and up to date on shots. Are they licensed within your municipality?
Provide the name of your veterinarian, phone number and the name under which pets are registered. If you do not have a veterinarian please state the reason.
Have you had pets in the past? If so, State what kind and what became of each pet.
Approximately how much time and work do you believe the dog for which you are applying to adopt will require and has you family discussed the responsibilities?
Approximately how much do you believe the pet for which you are applying will cost each week, month, or year in terms of food, supplies, medical care, toys, bedding,ect.?
Are you willing, able and prepared to provide the full cost of the care for this dog, including routine and emergency medical care, food, grooming, toys, ect.?
What would you do if the dog needed medical care that you could not afford? (there is no right or wrong answer here; we simply want an idea of how you would handle one of the difficult situatuions that could present itself.)
Do you expect to be moving, local or otherwise in the near future? if so, will you be taking this dog with you?
What are you looking for in a dog? What characteristics appeal to you most -e.g., playful, protective, rugged?
Do you travel on business or vacation? if so, who will care for this dog while you are away from home?
Have you ever been convicted of a crime to include animal neglect or abuse? if so, please set forth the details of that conviction. We do check!
Are there any circumstances or behaviors that would cause you to rehome a pet or take it to a shelter?
Do you have other requirements for the dog you adopt -e.g., good with cats, dogs, kids, crate trained, ect.?
Would you prefer a male or female dog?
Does your town or municipality have any breed restrictions?
Are you prepared to enroll in training classes?
Will you crate train?
How would you characterize your life style? -e.g., Always on the go, home-bodies
Have you applied for a dog with any other rescue?
If you have anything to add, please use this space. If you were referred by someone list their name.
Please keep in mind that we are a volunteer organization. Your application may take 24 to 48 hours to process. 2017 adoption fees are $325 for dogs under 1 year of age and $275 for dogs over 1 year of age