Please enter your full legal name
Your Date of Birth
Name of pet you would like to adopt
Would you like to adopt a second dog/puppy (littermate/bonded pair)?
Name of second pet
Please enter at least one phone number below
Co-applicant for this Adoption (if any)
Is there a co-applicant ?
Your relationship to the Co-Applicant
Tell Us About Your Home
Do you live in a:
Do you own or rent your home ?
Landlord's Phone Number
Landlord's Email Address
Landlord's Mailing Address
Do you have a fence?
Do you have a doggie door?
How often will your dog have access to the door?
About Your Household
HUMAN Household Members
List HUMAN household members, ages, pet responsibilities
Do all adults work outside of the home full time?
Is anyone in your home allergic to pets?
Are you or anyone in the household a smoker?
Does everyone in your home know that you are interested in bringing another animal into the home?
ANIMAL Household Members
Please list your ANIMAL household members (Age, breed, sex, spayed/neutered, and date of rabies vaccination). Please include any that have passed within the last 12 months.
List the temperment of the dog(s) in your house, if you have any dogs.
Are your current pets spayed and neutered?
How many pets have you owned previously?
Why do you want to adopt a pet?
Companion for me
Companion for another pet
Are you adopting a pet to live:
Have you ever had to relinquish a pet?
Describe the type of situation where you might have to give up the dog
For which of the following reasons would you consider giving up your dog? Check all that apply.
Fights with other pets
No reason I would give up my pet
Kids no longer want
Messes up the furniture
What do you think are the most important responsibilities in owning a dog?
Do you believe in crate training?
Only to potty train a puppy
How many hours would your dog spend in a crate?
What behaviors are you not willing to tolerate from a pet?
How will you correct these behaviors?
What do you do with your dog when you are out of town?
Where do your pets spend most of their time?
Where will your pet sleep?
How many hours per day would your dog be left alone?
Where will your pet stay when home alone?
Are you prepared to care for a pet for up to 15 years?
Can't be sure
How much money are you able/willing to spend if the pet becomes sick or injured?
$500 or less
$1,000 or less
Whatever it takes to provide appropriate care
What brand/type of food are your current pets, or will your future pet be eating?
How do you plan to exercise your pet?
Are you prepared to keep your pet groomed (if required) every 6 to 8 weeks?
Are/will your pets be regular on:
Annual vet checks
Are you willing to let a SNAP representative come for a home visit before or after adoption?
Yes, with notice
Your veterinarian's name
Your veterinarian's phone
May we call your vet to confirm your pets are altered and vaccinated?
Can you please provide us with two personal references?
Name and phone or email for first reference
Name and phone or email for second reference
What else should be know?