Form

Dog Adoption Application

Please complete this adoption application as fully and honestly as possible. Incomplete applications will be discarded. Completion of this application does not guarantee adoption of one of our dogs. IF YOU ARE NOT WILLING TO DRIVE TO ORANGE COUNTY TO MEET THE DOG YOU ARE INTERESTED IN, PLEASE DO NOT COMPLETE THIS APPLICATION! We know that this is a long application, but please understand that our goal is to find the best fit between human and animal. Thank you for your interest in rescue!
Today's Date
Name of dog you are interested in:
How did you hear about this dog? Please give website if applicable.
ABOUT YOU
Full Name
First Name Last Name
Full Name of Spouse/Significant Other
First Name Last Name
If this relationship were to change, who would keep the dog?

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone Number
- Area Code Phone Number
Cell Phone Number
- Area Code Phone Number
Which number is best?
When is the best time to call?
E-mail
Your occupation:
Your spouse/significant other's occupation:
ABOUT YOUR FAMILY
What are the ages of all the members of your household, including yourself?
If not immediately related to you, what is your relationship to other members in your household?
If not immediately related to you, what is your relationship to other members in your household?
Are you expecting a child or planning a family?
Is anyone in your home allergic to animals or have asthma?
ABOUT YOUR HOME
What kind of home do you live in?

House Condo/Townhouse Apartment
Do you

Own Rent
If you rent, please provide the name and phone number of your landlord.
If you rent, have you received permission from your landlord to have a dog?
If you rent, has your landlord placed weight or breed restrictions?
How long have you lived at your current address?
Do you have a yard completely enclosed with fencing?
ABOUT YOUR CURRENT/PREVIOUS PETS
Will this be your first dog as an adult?

Yes No
Please list all current pets, including ages and breeds/mixes.
Please list pets you have had in the past few years but no longer have. Please explain why you no longer have these pets.
Have you ever been in a situation where you were unable to keep a pet?

Yes No
If yes, please explain, including what ultimately happened to the pet (given to a friend/relative, was euthanized, surrendered to animal shelter or rescue group, etc.)
ADOPTION INFORMATION
What percentage, on average, will the dog be outdoors each day?
Where will the dog be when you are at home? Be specific.
Where will the dog be when you are out of the house (i.e. at work, not on vacation)
Are there any parts of the house into which the dog will not be allowed?
Where will the dog sleep? Be specific.
Is anyone home during the day? Who?
How many hours, on average, will the dog be alone (i.e. without human supervision) each day?
What will you do if the dog has potty-training issues?
Who, besides your family, will have access to your property while you're away from home? (gardener, pool cleaner, housekeeper, etc.)
Do you understand that the whole history of a rescue dog may be unknown and you may encounter some initial problems?
What will you do if the dog chews, digs, or has other behavioral issues?
If you have had dogs previously, did you seek a professional trainer or did you train yourself?
Would you be willing to consult a professional trainer if the dog acquires issues you are unable to handle?
What arrangements will be made for the dog when you travel?
What will happen to the dog if you move? Please don't respond with "we don't plan to move".
What circumstances would cause you to give up the dog?
Current Vet's Name

Current Vet's Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Current Vet's Phone Number
- Area Code Phone Number
What is a reasonable amount for you to spend if your dog needed medical attention?
Please provide a the name and phone number of someone not related to you.
If you have any additional notes, please add them here:
Are you ready and able to make the tax-deductible adoption donation? It generally ranges from $250 (for adult dogs) to $375 (for puppies 6 months and under).

Yes No
Should be Empty:

Dog Adoption Application

ABOUT YOU

ABOUT YOUR FAMILY

ABOUT YOUR HOME

ABOUT YOUR CURRENT/PREVIOUS PETS

ADOPTION INFORMATION