Forms

Adoption Application

We understand that this application can seem long, but please be assured that all the below information is completely necessary to completing the adoption process.

Adoption Application

* (denotes required field)

Who You're Looking For

Name of dog you're interested in (from web site, flyer or Facebook):

If you're not sure what age of dog would you like to adopt?:

Male or Female?:

Size?:

What are you looking for in a dog?

What do you most like about dogs?

What do you like least about having a dog?

Who are you adopting the dog for?:

Who will be the primary caregiver of the dog?

How soon were you looking to adopt?

General Information

Email: *

First Name: *

Last Name: *

Home Address: *

City: *

State: *

Zip Code: *

Home Phone: *

Cell Phone:

Occupation:

Employer:

Are you over 21 years old?:

About Your Home

Type of Residence:

How long have you lived there?

Rent or Own?:

Please list your last previous address and length of time living there.

Please list all those living in residence (name, relation, age)

Residents

Please list any companion animals currently living in this household.

Pet 1

Name

Cat or Dog:

Cat Dog

Breed

Sex:

Male Female

Age

Spayed/ Neutered:

Yes No

Pet 2

Name

Cat or Dog:

Cat Dog

Breed

Sex;

Male Female

Age

Spayed/Neutered:

Yes No

Do you have a backyard or terrace?:

If yes is it enclosed?:

If you have no yard, how will your dog relieve/exercise himself?

Have you ever had a dog previously? (Please provide a brief history. If deceased, state name and date of death)

Have you ever taken a pet to a shelter? Please explain.

What is your household activity level?:

How many hours are you gone a day?

Do you travel often?:

Who will care for your pet when you travel?

Do all adults work full time?:

How many hours a day will your new dog be alone?

Where will your new dog be kept when he is alone?

Where will your new dog be kept during the day?

Where will your new dog be kept during the night?

What sort of training do you plan on providing?

Who will walk your new dog? And how often?

Who else will be spending time with your new dog?

Is a home visit OK?:

The following information is required so we can verify that you are allowed pets.

If you rent are you allowed pets?:

Does your rental agreement specify a size restriction?:

Landlord's Name:

Landlord's Phone:

Landlord's Address:

Do you have a local veterinarian?:

Vet's Name:

Vet's Phone:

Vet records are under the name of:

How did you find out about DRWB?

Please provide any other information that may be helpful for us to know when reviewing your application

DONATION - Dog Rescue Without Borders requests a donation ranging between $100-$350. Is this acceptable to you?:

By submitting this form I certify that the above information is true and accurate to the best of my knowledge, and I understand that completion of this form in no way guarantees my ability to adopt a dog. I further understand that completion of this form is only the first step in the adoption process and that, should I wish to further this process, and in-home screening will follow.

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