Adoption Application Dogs | Rescue a homeless dog or puppy

Name of dog you are interested in*

If this dog is no longer available, what are you looking for in a dog so that we can try to match you to another?

Date*

How did you hear about this dog?*

ADOPTER INFORMATION

Name*

First Last

Spouse/Significant Other’s Name*

Address*

Street Address City State ZIP Code

Home phone*

Cell phone

Email*

List ages and relationships of all people who live in this home, please include yourself:*

Do you plan to have children within the next 3 years?*

Yes
No

REFERENCES

(Must be someone other than an immediate family member)

Personal Reference Name*

Phone*

How you know this person*

Your Employer*

Phone*

How long have you been employed there? How many hours a day do you work?*

Spouse/Significant Other's Employer*

Phone

How long is your spouse/significant other been employed there? How many hours a day does your spouse/significant other work?

REASON FOR ADOPTION

1. Why are you considering adding a pet to your life? (check all that apply)*

Companion for Children
Companion for Adults
Companion for other pets
Companion for Family
Working dog
Protection
Other

2. Does everyone in the house want a pet?*

3. Do any family members have allergies or asthma?*

4. Will this animal be given as a gift?*

5. Have you ever owned pets before?*

6. If yes, how long did you have your pets?

7. If pet(s) is/are no longer with you, what were the circumstances of the passing or absence?

8. What other pets live with you? Check all that apply:

Dog(s)
Cat(s)
Other

Please indicate below for each pet, the pet’s sex, if spayed/neutered, breed, and age:*

HOUSING

9. Do you live in a:*

House
Condo
Apartment
Mobile Home
Military Housing
Other

Other Housing

“How long have you lived at this residence?”*

Do you plan on moving in the next 3 years?*

Yes
No

If yes, what will happen to your dog if you move?

10. Do you own or rent your home?*

Own
Rent

If you own, what name is the home ownership under?

If renting, do you have your landlord’s permission to have a pet?

Yes
No

If renting, may we contact your landlord?

Yes
No

Landlord’s name

Phone

11. Do you have a yard?* Is yard fenced?*

Yes
No

Height of yard fence

12. Do you have a pool?* Is pool fenced?*

Yes
No

Height of pool fence

13. Where will your new pet be when you are not at home?*

14. If your pet will be outdoors, will he/she be chained or tied up?

Yes
No

What will a typical day look like for your dog?

15. How many hours per day will your pet be left alone?*

Where will your pet sleep at night?*

16. May we visit your home for a basic safety and security check?*

Yes
No

17. Do you have the time and will you make the commitment to train your new pet should behavior concerns arise?*

Yes
No

What steps would you take if your new dog began to have behavior issues or was not fully house trained?*

18. Pets are an addition to the family, and as such will require investment of your time and money for medical care, grooming, appropriate food, water, proper shelter, clean environment, exercise, attention, affection, and protection from harm. Are you willing and able to provide the appropriate resources that your new pet requires?*

Yes
No

How would you handle the dog if he/she suddenly needed expensive medical care ($1,500 or more)?*

VETERINARIAN

Veterinarian

Phone

Vet’s clinic or hospital name:

Sometimes pets out-live us. In the event you can no longer care for your pet, has anyone already agreed to take your pet for the duration of the pet’s life?

Yes
No

If yes, name of person & relationship: Phone / Email:

This pet must not be passed into other hands or relinquished to an animal shelter of any kind. Do you agree that if for any reason you could not keep this pet you would contact SPOT?*

Yes
No

Please contact SPOT with least one week notice for return to allow us time to find a foster home. Call 760-593-7768

I CERTIFY THAT THE ABOVE IS TRUE, AND THAT ANY FALSE INFORMATION MAY RESULT IN NULYFING MY APPLICATION. I AGREE TO ACCEPT THE DECISION OF SPOT REGARDING THE SUITABILITY OF ADOPTING A PET. I UNDERSTAND THAT SAID DECISION IS FINAL AND IF NOT APPROVED, NO EXPLANATION OR JUSTIFICATION IS NECESSARY. I ALSO UNDERSTAND THAT FILLING OUT THIS APPLICATION DOES NOT GUARANTEE THAT I WILL BE SELECTED TO ADOPT THIS ANIMAL.

DIGITAL SIGNATURE*

Please type your first and last name above.

If you would like to have a copy of the form please print this document before submitting

Email

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ADOPTION APPLICATION – DOGS

ADOPTER INFORMATION

REFERENCES

REASON FOR ADOPTION

HOUSING

VETERINARIAN