Canine Adoption Application Fill out the form below to apply to adopt a dog! Apply Online Name of Animal0/50Breed0/50Age0/50Sex Male Female *Your Name0/80*Date of Birth*Phone Number0/15*Email Address0/50*Street Address0/50*City0/50*State0/15*Zip Code0/5*Are you a US citizen or permanent resident? Yes No *Driver's license / Identification Number0/50*Place of Employment0/50*Employer's Phone0/50*Occupation0/50*How long have you been employed there?0/50*Are you a student? Yes No School Name0/50Expected Graduation Date0/50*Have you ever had to get rid of a pet? Yes No If yes, have you surrendered to us previously? Yes No *Please provide a reference (family member okay).Name, phone/email, relationship.*Please provide a reference (must be non-family).Name, phone/email, relationship.*Residence House Condo Apartment Mobile Other *Do You Rent Own Live with parent/guardian Other Landlord / Condo Association / Guardian ContactName, phone number, emailAre pets allowed? Yes No Are there breed restrictions? Yes No Is there a weight limit? Yes No *Do you own a crate? Yes No *Please list everyone 18 or older living in your home.*Please list everyone under 18 living in your home.*Has anyone living in your home been convicted of a felony? If yes, please explain.*Motivation for Adopting Family Pet Child's Pet Companion for other pet Guard dog Gift Other *How much money do you think you will spend on pet care each year?*Who will be responsible for the exercise, grooming, health care, and feeding of the pet?*How long do you expect to commit to the dog?*Where will the dog be kept during the day and night?*How will you keep the dog on your property when outside? Fence Invisible Fence Kennel Leash Tie-Down Run Loose Other *How will you exercise the dog?*How will you handle barking, chewing, scratching, digging, and other destruction?*Under what circumstances would you not keep the dog? Allergy Current pet not adjusting New baby Biting Moving Other *Please provide information on all the pets you've had over the last five years.Name, species, sex, age, spayed/neutered?, indoor/outdoor?, current location of pet, vet office (including name and city).*I certify that all the information in the form is correct. I understand that ABD reserves the right to refuse the adoption of any animal to any person for any reason. Yes No *Print Name*Print DateNotes Fields with (*) are compulsory. Application Progress
