Saving Grace and Her Furry Friends » Adoption Application

Please note: Items marked with an asterisk (*) require a response.

Name of Dog you are interested in:

Applicant’s Name:

Age of Applicant:

Number of adults your home:

Do children live in your household?

Yes No

Name(s) of everyone that lives with you:

Age(s) of those that live with you:

Do you have children that visit your home?

Yes No

How often do the children visit?

Visiting children's ages:

Your Contact Information:

Applicant's Phone Number

Additional Phone Number

Applicant's Email Address:

Applicant's Address:

Street address

City

State / Province / Region

Zipcode

Profession(s):

Work Phone Number:

Hours and days of work (including commute):

Do you live in a:

House

Townhouse

Condominium

Apartment

Would you agree to a home visit to ensure the safety & security of the pet?

Yes No

Do you:

Own Rent

Do you have an enclosed yard?

Yes No

How tall is the fence?

Do you have a pet size, weight, number of pets allowed limit where you live?

Yes No

If yes, please describe:

Landlord's name & phone number (if you rent):

May we contact your landlord to confirm pets/sizes are permitted?

Yes No

Why do you want to adopt a dog?

What type of breed are you most interested in?

What do you know of this breed? Have you done any research?

Preferred Dog Gender

Male Female No Preference

Age range

Hair type

Activity Level

Size

Type of Activity

Is anyone in your family allergic to dogs or cats?

Yes No

If so whom?

What will you do if a member of the household is allergic to the dog you are adopting?

Where would the dog stay during the day?

Indoor

Outdoor

Both

Do (will) you crate your pets?

Yes No

If so, how many hours at a time?

REFERENCES:

Veterinary Reference:

(current or previous vet to contact for vet reference)

Veterinary Name

Phone Number

1st PERSONAL REFERENCE:

First Personal Reference Full Name

Phone Number

Relationship

2nd PERSONAL REFERENCE:

Second Personal Reference Full Name

Phone Number

Relationship

I certify that all information in this application is true, and I understand that false information may void this application. I agree that upon adopting a pet from Saving Grace, I will agree and abide by their Adoption Agreement.

Signature

Date