Adoption Application

(This form can be used and modified as needed for your organization to gather information from prospective adoptive individuals.)

First Name

Last Name

Address 1

Address 2

City

State

Zip

Primary Contact Phone

Occupation

What kind of home do you have?

Do you own or rent your home? NOTE: WE VERIFY OWNERSHIP ON ALL ADDRESSES!

Please list NAME and PHONE NUMBER of your landlord if you are renting. If you own a condo or townhouse, please provide the phone number of your HOA. We need this information in order to proceed with your application and call them before we call you.

How long have you lived here?

Do you have a yard?

Is the yard completely fenced?

Please attach pictures of your FENCE and GATES! If you are unable to upload images, please send them to info@sheprescue.org with your name.

Do you have a pool?

If so, is the pool fenced?

Enter the FULL NAME and AGE of the main caregiver of the dog. Also enter the FULL NAMES and AGES of all the other members of the household. NOTE: Please be honest about your age. We verify all information online. Not adding this detailed information will slow the processing of your application.

What kind of dog are you looking for? Tell us about what you want in a dog and what its life will be like with you.

Where will the dog be housed during the day?

Do you have a doggy door?

How many hours a day will the dog spend alone without humans and where?

How do you plan on exercising your dog and how often?

Where will the dog sleep at night?

Please attach a picture of the dog's sleeping quarters.

Why are you choosing a dog?

What other dogs have you had in the past and what happened to them? (include breeds)

Are you willing to take your dog to obedience class?

If you answered 'NO' above, why are you not willing to take your dog to obedience class?

If you answered 'YES' above, what kind of obedience class would you take your dog to?

Medical costs can be high if your dog gets injured, develops an illness, gets bloat, etc. Are you able to afford the medical care your dog might require throughout his/her lifetime which can run into the many thousands?

Do you need recommendations for pet insurance carriers?

List any reasons that would make you return the dog you adopt.

Please list the breeds, age and gender of the dog(s) you currently have and if they are spayed/neutered.

Do you have cats? NOTE: no placement into out-of-state homes with cats or small dogs.

IF you have cats, have they lived with a dog before?

Please tell us about your other pets (birds, caged critters, snakes, livestock etc), any family members with special needs, and anything else that may help us find the right pet for you.

Do you currently have a veterinarian?

If you currently have a veterinarian, please provide their name and phone number.

Did you thoroughly read and understand the bios of the dogs you are interested in?

List the names of the dogs you were interested in.

How did you hear about our organization?

Please provide any other information that you might consider helpful: