Dog Adoption Application Form

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Courtesy Dog Adoption Form
Contact Information
Full name:
______________________________________________________________
Occupation: ______________________________________________________________
Address:
______________________________________________________________
How long at this address: ___________________________________________________
Phone: __________________________________________________________________
Email address:
__________________________________________________________
Family & Housing
How many adults are there in your family (their relationship to you)?
_________________________________________________________________________
How many children (ages)?
_________________________________________________________________________
What type of home do you live in single family, town home, apartment, farm, etc.?
_________________________________________________________________________
Please describe your household: __ Active __ Noisy __ Quiet __ Average
If you rent, please give the rules governing pets and the landlord’s name and number:
(By providing this information you are allowing the dog’s owner to contact your landlord. Please
inform them of this call so they will speak with us)
Does anyone in the family have a known allergy to dogs?
_________________________
Is everyone in agreement with the decision to adopt a dog? _________________________
Do you have time to provide adequate love and attention? _________________________
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