Dog Application Form (Page 3 of 3) in pdf

YOUR HOME

1) Do you own or rent your home?

Own

Rent

2) If you rent your home, do you have your landlord’s permission to have a dog?

Yes

No If Yes, provide a letter from your landlord

3) Where will the dog be kept during the day?

Loose in the home

Tied outside

Garage

Loose outside

Crate

Kennel run

With me

Other: __________________________________________________________________________________________

4) Where will the dog stay during the night?

Loose in the home

Tied outside

Garage

Loose outside

Crate

Kennel run

With me

Other: __________________________________________________________________________________________

Names and telephone numbers of 3 adults (who do not live with you) we can contact for references. No family members please.

1) ___________________________________________________________________________________________________

2) ___________________________________________________________________________________________________

3) ___________________________________________________________________________________________________

Is there anything else you would like to tell us to support your application?

_____________________________________________________________________________________________________

All of the information I have given above is true and complete. The dog will reside in my home as a lifetime companion. I will provide

him/her with adequate food, water, shelter, training, affection and regular vet visits. If the dog I wish to adopt is not spayed or neutered,

I agree to have this done within 4 months of the adoption.

I give permission to Hay River SPCA to verify any information that I have given on this application. I understand that this application must

be approved by the Hay River SPCA Adoption Committee, and full payment must be received before I take possession of any dog. If for

some reason this agreement is cancelled by me within one week, I am entitled to a full refund.

I am in full agreement with the above terms of adoption. The Hay River SPCA is in no way liable or responsible for any damage, accident

or injury resulting from the placement to a dog into my household.

Applicant Signature: __________________________________________________ Date:___________________________________

Thank you for completing this application.

This information will help us match you with the right dog for your family.

It can take up to 7 days for your application to be processed and we ask for your patience during this time.

Dog Application Form Page 3