Canine Adoption Application Canine Adoption Application Dog’s Name * Age * Sex * Name * Name First Name First Name Last Name Last Name Date of Birth * Phone * Email * Address (street, city, state, ZIP) * Are you a US citizen or permanent resident? * Yes No Driver’s license / Identification Number Residence type * House Condo Apartment Mobile Other Do you * Rent Own Live with parent/guardian Other Landlord / Condo Association / Guardian Contact Name, phone number, email Are pets allowed? * Yes No Are there breed restrictions or a weight limit? * Do you have a crate? * Please list everyone living in your home, including names and dates of birth * Have you or anyone living in your home been convicted of a felony? If yes, please explain. * Place of Employment * Employer’s Phone Occupation * How long have you been employed there? Are you a student? * Yes No School name Expected graduation date Have you ever had to get rid of a pet? * Have you surrendered to us previously? * What is your motivation for adopting? * 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 exercise the dog? * How will you handle barking, chewing, scratching, digging, and other destruction? * Under what circumstances would you not keep the dog? * Please provide information on all the pets you’ve had over the last five years * For any animals owned in the past five years, living or deceased, who is your veterinarian? * Please provide a reference (family member okay) * Please provide a reference (must be non-family) * 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 Submit If you are human, leave this field blank. Δ
