APPLY TO ADOPT Fill out the adoption form below! Step 1 of 6 16% Name of Dog* Date* MM slash DD slash YYYY Full Name* Email* Home Address* City* State* Home Number* Mobile Number* I live in a*I live in aHouseApartmentCondoMobile HomeDo you own or rent your current home?* Rent Own If you RENT your home, are pets allowed? Yes No Is there a weight limit? Yes No What is the weight limit? Is a pet deposit required? Yes No What is the deposit amount? Please provide landlord contactiInformation*Occupation / Employer* Do you travel frequently?* Yes No When you are away, who will care for the dog?* How many hours per day will the dog be alone?* Where will the dog be kept during the day?*How long do you plan to keep this dog?* If you lost your job or had to move, or if the dog grows larger than expected, what would you do with the dog?*Where will this dog be kept during bad weather?* Where will the dog sleep at night?* How do you plan to house train the dog?* If this dog develops behavioral problems such as chewing, digging, etc, what measures will you take?*Will you train this dog? If so, how?*Do you plan any physical alterations?* Yes-Ear cropping Yes-Tail docking Yes-Other No Please check all equipment below you plan to use for this dog:* ID tag Tattoo Microchip Crate Dog run Dog Collar Dog House Electric Fence Invisible Fence Chain Groung Tie-Out Doggy Door Dog Bed Bark Collar Would you agree to take your companion dog to the veterinarian for yearly check-ups and keep him or her on heartworm preventative for life?* Yes No May we contact your veterinarian for a reference?* Yes No Please provide veterinarian contact information (Clinic Name: Vet’s Name: CityPhone:)Have you ever surrendered, given away or given up an animal?* Yes No To whom did you give the animal?* If so, describe the circumstances in detail:*Why do you want to adopt a companion animal?* Companion for me Companion for a child Companion for other pet Protection Gift Other Why do you want to adopt a companion animal? If other, please explain:* Do you have a securely fenced yard?* Yes No How high is the fence?* Total # of adults in household:* Total # of children in household:* Do children/grandchildren visit your home?* Yes No Provide any additional information that you feel is relevant to this application, such as any experience you have with special needs pets or prior pet ownership experienceHave you previously had pets in the home?* Yes No Do you currently have any pets in the home?* Yes No Please tell us about other current pets, such as type, age, temperament, suitability with other animals* Consent*I certify that the information provided on this application is true and correct. I understand that providing false information or withholding information on this application can be considered a violation of the adoption agreement and result in Straydog reclaiming this pet. I certify that the information provided is true and correct.CommentsThis field is for validation purposes and should be left unchanged.
