First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

Text/Pager Email

Which animal are you interested in?*
Choose an animal: Brie Bubba Sparx Croquette Ginger Spice Norah Tootsie Roll Zooey

Employer*

Occupation*

Date of Birth*

Co-Applicant Name

Co-Applicant DOB

Co-Applicant Employer

Co-Applicant Occupation

Co-Applicant Email

Co-Applicant Phone

Do you live in a:*
Choose one: House Apartment Townhome/Condo Duplex Other

Your Home: Do you*
Choose one: Own Rent Live with Family

If rent, please provide name and address of landlord

If Rent: Do you have landlord's permission to have a pet?

If Rent: What is the pet deposit:

Are you planning on moving in the next 2 years?

How long at current address?*

Do you travel for work at all?

If yes- how much of the time are you out of town?

Is your yard fenced in securely for a dog with no holes or gaps at the bottom?

If Yes-How tall is your fence?

If Yes-What kind of fence do you have?

If Yes- Is there a gate on the fence, if so, does it have a lock?

If No- how will the new dog be exercised and where will it go to the bathroom?

Do you have a swimming pool?

If Yes- is it fenced?

How many adults are in your house? *

How many children are in your house?*

Ages of children

Is there anyone in your home with pet allergies?

Do you have pets in your home currently?

Please list breed, age and sex of all pets in your household:

Are all dogs and cats currently in the home spayed and/or neutered?

If No, is there a particular reason they are not altered?

How many dogs have you owned in the past (as an adult)? *

What happened to them? Be specific (dead is not specific, please tell us how/why):

Have you ever had to find your pet another home for any reason?

If yes, Please explain:

What circumstances to you are acceptable to find your dog another home?

Why are you looking at getting a pet now?*

What energy level would you like? *
Choose one: Low Medium High

Where will this dog stay when no one is home? *

Where will this dog sleep?*

Will the animal be allowed on the furniture?

If you don't have a crate, will you be willing to purchase one if the new dog needs to be crated?

Approximately how many hours will the new dog be alone during the day?*

Approximately how many hours will the new dog spend inside the house?*

What type of housetraining methods will you use?*

How would you discipline your pet if it misbehaved (got into the trashcan, ate your shoes, etc?*

How will you train your dog?*

What BRAND of food will you feed your pet?*

What would you consider a realistic cost to properly care for your pet for one year?*

Realizing pets can live up to 20 years, are you committed to a new pet for the duration of their life?

If something were to happen to you, what would happen to your pets? *

If your pet has any behavioral problems, in the future, what would you be willing to do? *

What if your pet comes down with a serious medical problem that's very expensive, what would you do?

What activities do you plan to do with your new dog?*

If you decided to move to a place that didn't allow pets, what would you do?*

Most pets require time to adjust to their new home. How much time are you willing to give this pet? *

Are you planning on enrolling this dog in obedience classes?

Do you expect any major life changes within the next 10 years - marriage, children, etc?

Do you think dogs should be allowed off leash in an unfenced area?*
Choose one: Yes No Depends on the dog

Will the dog have access to a raised balcony, patio or porch?

Is there anything else that you would like us to know?

What is your vet's name, address and number?*

Please provide three personal references that we may call to verify information above. Name, phone number and relationship*

Please confirm your email address*

You understand that you are in agreement and compliance to our application process and agree that everything on this application is true.*
Choose one: Yes No