Dog Adoption Application Please fill out the form below, and hit ‘send’ when you are done. We will review your application and get back to you shortly. Today's Date * MM DD YYYY Name of dog you wish to adopt * Name * First Name Last Name Date of Birth * MM DD YYYY Home Phone (###) ### #### Mobile # * (###) ### #### Work Phone (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Employer and Occupation * Driver License # and State * Spouse or Partner's name First Name Last Name Spouse/Partner Date of Birth MM DD YYYY Spouse/Partner Phone (###) ### #### Spouse/Partner Employer and Occupation Please answer the following questions: Briefly describe why you would like to adopt a dog. Briefly describe why you have selected this particular dog to adopt. Do you feel adopting an animal is a lifetime commitment? If so, why? What could happen in your life that would make you give up this pet (pregnancy, moving, new relationship, etc.)? Have you consulted with your spouse/partner/roommate regarding this adoption? Yes No N/A How does your spouse/partner/roommate feel about a dog? HOUSEHOLD : Do you live in (choose one): House Townhouse Condo Mobile Home Apartment Complex Do you rent or own? Own Rent If renting, please provide landlord’s name and number: Do you have permission from the landlord to keep a dog? Yes No N/A Are there breed or size restrictions where you live? yes no If yes, please explain Please indicate yard size: Large Medium Small None How tall is your fence? About 4 ft About 5 ft About 6 ft None Is your yard completely fenced? yes no Do you have a dog run or dog house? yes no Please list the names and ages of all your household members: Who will be primarily responsible for the care and supervision of the animal? Will this dog be in the presence of children frequently? yes no If yes, what ages? Do any household members have known allergies to dogs? yes no Please list the pets that you have had in the past five years (both current and those you no longer own) Breed/Type Age Sex Spayed or Neutered How long was this animal a part of your family? What happened to him/her? PET CARE: Do you have a veterinarian for your pet(s)? yes no Provide the name and phone number of the Clinic: If you have current animals, what is the approximate date of their last vaccinations: What will happen to this dog if you move? The lifetime cost of providing guardianship to an animal can cost thousands of dollars, especially if surgery or chronic disease requires long-term care. Are you able and willing to support a pet financially for its entire life? yes no Where will your dog be kept when you are home? (Examples: basement, garage, loose indoors, loose outdoors, in a crate, locked in bathroom, ect) Where will your dog be kept when you are not home? (Examples: doggy day care, basement, garage, loose indoors, loose outdoors, in a crate, tied up outside, etc.) Where will your dog spend the night? (Examples: basement, garage, loose indoors, loose outdoors, in a crate, tied up outside, etc.) On the average, how many hours per day will the dog be alone? How will the dog get exercise? How much exercise will your dog receive per day? Have you ever had to surrender an animal? If so, please describe the reason for surrender: ANIMAL SELECTION/BEHAVIORS: As an adult, have you owned a dog? yes no How active a dog do you want? Agility, Running, Companion, Walking, Companion, Lounging. When did you last housetrain a dog? What method did you use? What is your method of correcting poor behavior in an animal such as jumping, chewing things they shouldn’t, etc. What type of obedience training will you provide? *Attend classes, private lessons, your own training, ect? Please describe the activity level(s) at your home. (example, we mostly hangout inside and watch tv; we like to go on hikes, etc.) For what potential problems do you feel unprepared and can use additional guidance? (Josie’s Misfit Ranch will work with you on preparing for your animal if you are approved to adopt. Please check all that apply.) Biting Not good with children Excessive activity level Separation Anxiety Accidents in house Excessive chewing Medical Issues Not good with other animals Excessive grooming need Confinement issues Other If you selected other (please explain): ANIMAL APPLICATION AGREEMENT By printing your name below you are verifying that all information on this application is accurate and truthful to the best of my knowledge. This application does not guarantee adoption and will be reviewed at the discretion of Josie’s Misfit Ranch who reserves the right to refuse adoption to any applicant for any reason. My signature also gives Josie’s Misfit Ranch permission to conduct a background check to ensure all animals are placed in appropriate homes. * Thank you for your interest in adopting a dog. We will get back to you shortly.
