Shannon's Companions

Helping Those That Can't Help Themselves

Dog Adoption Application

Name: Address: City, State, Zip Code, County: Phones: Email: Who is your vet? Phone number?
Please list the members of your household and ages.
Who will be primarily responsible for the care of the animal? Where will the animal live during the day? Night? How will this dog be allowed to relieve itself daily?
I will walk it on a leash.
I plan on training this dog to stay in my yard.
I have a tie out trolley or stake.
Other
How will you allow this dog to run and get exercise?
I will walk it on a leash for _____ miles every day.
I have a large yard the dog can run in.
There is a large park or field nearby.
Other: _____________________________
Please put the following in order of importance to you: I want my new dog to:
play with my other dog
play with my children
go walking or running with me
be affectionate and cuddly
be a good watch dog
become a performance dog (agility or flyball)
be trained and shown in obedience
be very laid back and calm
have lots of energy and exuberance
be totally housetrained
not be shy with strangers
Please tell us which statement describes you best:
I want to adopt a dog that has special needs. I really enjoy rehabbing and helping the needy dogs.
I want to save a dog's life by adopting a dog that no one else may want.
I am only interested in adopting a young, healthy, well-mannered dog.
I will adopt the dog that needs me the most.
Why do you want to adopt a rescue dog?
Will the animal have the run of the house, be blocked off from parts of the house, use a crate, be tied outside, or live in the yard - please explain?
If the need arises will you be willing to take an obedience class? Do you have a budget for emergency medical care if needed? Describe your family's lifestyle:
What qualities/personality traits are you looking for in a dog?
Are you prepared to make a 10 to 15 year commitment to a dog? Does any member of the family have any allergies to animals? If a behavioral problem arises, what steps will you take to work on it?
Describe the kinds of personal situations where you might have to return your adopted dog, i.e., job loss, children, move, marital change, etc...
Are there lifestyle altering events that could occur in your foreseeable future? What will you do with your dog while you are away on vacation or out of town?
Please list other pets, ages and if they are spayed or neutered?
Have you considered the extra expenses that will come with having a dog including vet care, food, supplies and equipment, toys, training and boarding? Please explain:
Have you ever crate trained a dog? Have you ever obedience trained a dog? Is your residence:
house
condominium
apartment
Are pets allowed?
town
city
rural
Is someone home during the day? If not, how long will the dog be alone (average)? Do you have a yard? Size? Is it fenced? What type of fencing? How high?
Have you had dogs/cats in the past? If yes, how many? What breeds?
What happened to them? If you were unable to keep them, why?
How far are you willing to drive, in hours, to look at an animal? Do you prefer:
male
female
either
Do you have a color preference? Do you have an age preference?
puppy under 6 months
young 6 months to 1 yr.
adult 1 to 6 yrs.
older 6yrs or more
age does not matter
Do you have a breed preference? Please list breeds you would consider.
Electronic signature and date:

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