Adoption Application If you’re interested in adopting a dog, please complete our Adoption Application below. When complete click the “SEND” button. We will contact you shortly. Your First & Last Name (required) Name of Dog Phone Your Email (required) Subject Your Street Address Your City, State and Zip Code Names & Ages of all Household Members Have you ever owned a dog? YesNo Anyone in your household have pet allergies? YesNo How much time can you allow your dog to adjust to your new home? Circumstances that could result in return of dog: Job LossDivorceRelocationNew BabyIllnessBehavioralUnlikely Household activity level: LowModerateActiveVery Active How often will you walk the dog? How long will the dog be left alone on a typical day? Who will take care of your dog when you are away on vacation/trips? Will the dog be left with unsupervised children? YesNo Are you willing and able to pay your pet’s veterinary costs? YesNo Your Home Type? HouseApartmentCondoOther Own? YesNo If rental, may we contact your landlord? YesNo Please provide landlord contact information If rental, does your lease contain dog breed restrictions? YesNo If rental, does your lease contain pet size restrictions? YesNo Does residence have a yard? YesNo How high is the fence? Do you agree to have your home and property checked? YesNo Other Pets In Your Household Pet Type/Name #1 Spayed or Neutered? YesNo Indoor or Outdoor? IndoorOutdoor # of Years Owned Age Pet Type/Name #2 Spayed or Neutered? YesNo Indoor or Outdoor? IndoorOutdoor # of Years Owned Age Pet Type/Name #3 Spayed or Neutered? YesNo Indoor or Outdoor? IndoorOutdoor # of Years Owned Age Additional Information Name/address of your veterinarian May we contact as a reference? YesNo Veterinarian Phone Number Will the dog live InsideMostly InsideOutsideMostly OutsideOutside Only Will the dog spend nights InsideMostly InsideOutsideMostly OutsideOutside Only Where will dog stay when alone? InsideOutsideBoth Where did you hear about Lucky Dog Rescue? Any questions or comments, tell us more about yourself I am at least 21 years old. All of the provided information is true and complete. I understand Lucky Dog Rescue has the right to refuse my application. I understand the adoption fee of $250 is requested at the time of adoption to help us with veterinary, foster care and other expenses. A home visit will be required prior to adoption. I Agree
