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2. To apply to adopt a specific dog, please fill out this form.
   Please note: We would like to help you find the right dog and understand its needs, so please fill in as much information as possible. While we carefully monitor all our animals, and make sure they receive necessary veterinary care, we have limited knowledge of their backgrounds. Therefore, we cannot guarantee the health, behavior, temperament, age, or breed of any animal adopted. Also, please understand that you assume full financial responsibility for this pet, including any health care or training.
4. Dog you are applying to adopt
6. Name
7. Email Address
9. Phone Number
10. Work Number
12. Address
14. City
15. County
16. State
17. Zip Code
19. How long at this address?
20. If less than 2 years, previous address
22. List all the animals you’ve owned in the last 5 years. Please include breed, name, sex, age, spayed or neutered, time owned, where pet is housed, do you still own the pet, if not what happened?
24. Do you have a veterinarian?

    1. Yes
    2. No
25. If yes, give his/her name, and clinic name and phone number
27. Briefly, explain why you’d like to adopt a dog
29. Number of People in your Home
30. Adults
31. Children
32. Ages of Children
34. Who will primarily care for this animal?
35. Do you live in a house or an apartment?

    1. House
    2. Apartment
36. Do you own or rent your home?

    1. Own
    2. Rent
    3. N/A live in an apartment
38. If renting, please include the name and phone number of your landlord
40. Does any member of your family have allergies to animals?

    1. Yes
    2. No
    3. Not sure
41. What percentage of time will the dog be outside?

    1. 0-20%
    2. 20-40%
    3. 40-60%
    4. 60-80%
    5. 80-100%
42. Do you understand it may take time for this pet to adapt to his new environment and new family members? (More than 1 week)

    1. Yes
    2. No
44. What will happen to this animal if you are to move?
45. Under what circumstances would you give up your pet?
47. Are you willing to take responsibility for this pet for the next 10 to 15 years?

    1. Yes
    2. No
48. Do you understand that you are legally and humanely responsible for this pet?

    1. Yes
    2. No
49. Will you seek behavioral/obedience training if necessary?

    1. Yes
    2. No
50. Are you willing to allow a City representative conduct a home visit prior to adoption?

    1. Yes
    2. No
52. Are you aware that there is an adoption fee?

    1. Yes

    1. No
54. Digital Signature*
55. Date
    Date
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit Submit and Print

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