E-mail Address: * Your Name * Which dog(s) are you applying for? * Your Full Address (Street, City, State, and Zip Code) * Preferred Phone # * Alternate Phone # Place of Employment * Employment Address & Phone Number Spouse/Partners Name Spouses Place of Employment Do you rent or own your home? * Rent Own What type of place do you live in? * Home Apartment Mobile Home Condo Other If you rent, are pets allowed? Yes No If you rent, what is your landlords name and phone number? How long have you lived at this address? * Do you have any plans to move in the coming months? * How many adults live in your home? * 1 2 3 4 5 6+ How many children live in your home? * 0 1 2 3 4 5 6 7 8+ If you have kids, what are their ages? If you have kids, have they lived with a dog before? N/A Yes No Do you or anyone in your family have allergies to dogs/cats? * Yes - Dogs Yes - Dogs & Cats Yes - Cats No Unsure Why are you looking to adopt this dog? * What kind of training are you willing to provide this dog? * How much time do you have to work on training, exercising, house breaking, etc? * What kind of behaviors would you prefere Not to tolerate? Do you have a completely fenced in yard? * No Yes No, Partially Fenced No, Kennel Area If yes, how high is the fence? N/A 3 4 5 6 7+ If yes, what type of fence is it? N/A Chain Link Privacy Fence Combination Picket Fence Invisible/Underground Fence If no fence, how do you plan to traing or exercise this dog? If boundary training, do you have previous experience? N/A Yes No What are you looking for in a dog? * Do you currently own any cats or dogs? * Yes No If so, please list all of your pets. Please list the Name, Breed, Age, and Sex of each dog and cat in your home. If you have pets, please list the name and phone number of your current Vet Clinic Are you current on shots for all existing pets in thoe home? N/A Yes No (Explain in Comments) How how time are you willling to give this dog to acclimate to your home and current pets? * Where will this dog be kept during the day? * Where will this dog be kept at night? * Where will this dog be kept when left alone? * How many hours a day will this dog be left alone? * Please list two personal character references. (One may be your veterinarian if desired). Please list name, relationship, and phone number. * How did you hear about us? * Do you have any questions or comments that you would like to add to your application? If you confirm that all of the information in this application is true and factual, please type your full first and last name as a signature. * Pet Refuge, Inc. is an all volunteer, non-profit organization. We reserve the right to determine the appropriate home for each animal in our care. After submitting your application an adoption counselour will contact you within four days (hopefully sooner) and you will be asked to come in for an interview. If your application is approved, there is a 48-hour waiting period after which time an adoption counselor will set up a time to finalize the application. You will be required to produce a photo ID, sign an adoption contract, and pay any applicable adoption fees at that time. Thank you for your support of Pet Refuge, Inc.
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