Contact Information

Employment

Please List 2 Personal References (unrelated to you)

The Animal You Want To Adopt

Which animal are you interested in adopting?  If you have no specific animal in mind, please tell us what kind of dog you want to adopt... your preferences with regard to breed, sex, color etc:

Do you  have an age preference?  Please check all that apply.  Puppy (0 - 6 months) Young (6 months - 24 months)
Adult (2 - 7 Years) Senior (7 and up)  No Age Preference 

Is this your first pet as an adult?  Yes  No

Is this animal for : (Check all that apply)    Self   Family   Companion For Another Pet Breeding Gift Protection  Replace Previous Pet  Other - Please specify below

What other breeds have you considered?

Have you applied to adopt from another rescue within the last year? Which organization?

Information About Your Home

Which of the following best describes your current residence? (Check one)
Single Family Home  Mobile  Home  Condo Apartment

Do you own or rent?  Own Home  Rent/Lease Home
If renting, please plan on providing us with a copy of the pet policy from your lease and providing contact information so we may contact your landlord for confirmation.

Length of time at this address?

Is your property fenced?  Yes  No  Type of Fencing   Fence Height

Is the fence solid & secure?  Yes  No

Have you checked the yard for dangerous articles, plants or anything that the dog could use to climb the fence?   Yes  No

Can children or strangers gain access to your yard?  Yes  No

Is there a secure area for the dog to run?  Yes  No
If so, how large is this fenced secure area? 

Are any  improvements needed to make the yard secure?  How long is this likely to take?

Is there access to any bodies of water on the property (Pool/ Lake etc...)?   Yes  No
If yes, please explain:

Information About Your Household Members

Please list the people that currently live in your household.
(Please list relationship to you & their age.  We don't need the children's names.)

Does anyone in the household have any known allergies to animals?Yes No  If yes, please explain.

Your Current Animals

What animals currently live in your household? (Please include the following info for each pet: 
Name of pet, type of pet, sex/age, How long owned?  Kept where?)

Are all your current pets spayed or neutered?  Yes  No

Are your pets current on all vaccines?  Yes  No

Are your current pets on heartworm prevention?  Yes  No
If so, please tell us what brand and where it was purchased. 

Have you ever had any complaints about your pets?  Yes  No
If yes, please explain.

Are your current pets friendly with other animals? Yes  No  

Do your current pets stay primarily indoors or outdoors?  Please elaborate so we can get a good understanding of your pet's new life.

Your History With Animals

Please provide a description of your experience with dogs, including animals you may have owned in the past. Please include any experience with training or special activities.

Have you ever had to give up a dog before? What were the circumstances? Where did the dog end up?

Taking Care Of Your New Adopted Dog

What is the longest duration your pet will regularly be alone?  Less Than 3 Hours  3-6 Hours    6-10 Hours  Over 10 Hours

What is the longest duration you will leave your pet unattended outside?

Where will your new dog sleep?

Where will your new dog be when awake?

Approximately how many hours a day can you spend with the dog?

What would be your response if the dog made a mistake?

Are you financially prepared to give your dog the routine medical care it will require? Yes  No

Are you willing to accept that the dog may not like all your friends? YesNo

Have you discussed the pros and cons of adopting a dog with the members of the household?  Yes  No

Does everyone in the household want to adopt this dog?  Yes  No

If you should have to move or become unable to care for this animal, what will become of this pet?

Do you understand that there are no guarantees for house training, behavior, temperament, or health of an adopted dog and that adjustment periods vary for each animal?    Yes  No

Your Veterinarian

Do you have a veterinarian you have used before?  Yes  No

Date, pet name and reason for most recent vet visit.

We reserve the right to check your status with your vet and to inspect all homes and yards prior to approving any adoption.  Is this okay?  Yes    No

Almost Done!

How did you find out about SPOT?  (Please be as specific as possible - Vet, Shelter, Friend, Newspaper, Internet, Other)

Any other comments you'd like to add for consideration of your application to adopt?

Would you consider volunteering for our organization  Yes  Not At This Time
If yes, which of the following areas interest you?
Temporary Foster Care   Personal interviewing of adoption candidates   Fundraising   Home Visits
Transporting   Computer Assistance  Telephone calling  Representing us at an Adoption Event
Other   PLEASE SPECIFY  

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