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Bob's House for Dog's Adoption Application

*e-mail us for a paper application

You can make it happen.... Apply Now!

PERSONAL INFORMATION

Name *

First Name

Last Name

Email Address *

Date of Birth *

YYYY

Driver's License Number

State Issued

Primary Phone # *

(###)

###

####

Other Phone #

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Number of years you have lived at this address: *

Type of Residence *

Do you rent? *

Yes

If Yes, name of the Landlord

Landlord Phone Number

(###)

###

####

How many adults live in your household? *

How many children live in your household? *

Ages of the children:

Do you plan to move in the next 6 months? *

Yes

What are your plans for this dog if you move?

If yes, explain:

Does everyone in your household know your plans to adopt a dog? *

Yes

Is anyone in your household allergic to dogs? *

Yes

If yes, what are your plans to control these allergies?

Please rate your household activity level *

1 - Low Key 5 - Moderate 10 - Highly Active

Current Employment

Primary Employer

Number of years you've worked there

Full or Part Time?

Full Time

Part Time

Address of employer

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have other household income?

Yes

Other Employer Name

Full or Part Time?

Full

Part

Number of years you've worked there

ADOPTION INTEREST

What dog of ours are you interested in? *

Why? *

GETTING TO KNOW YOU

What is your dog ownership experience? *

Who will be primarily responsible for the dog? *

Where will the dog be kept? *

check all that apply

In the house (free roam)

In the basement

In a crate inside

In a closed-off room inside

In the garage

Tied up outside

Outside in a kennel

Other

On average how many hours per day will the dog be left alone? *

Are you familiar with crate training? *

Yes

Explain:

How would you resolve behavior problems such as chewing, barking, digging, fence jumping, etc.? *

Are there any behaviors that you would be unable to live with/tolerate?

Where will your dog stay if you travel or go on vacation? *

Have you ever adopted from this shelter? *

Yes

If Yes, when?

Have you not been chosen or declined? *

Yes

If Yes, please explain

Have you adopted from another shelter? *

Yes

If Yes, when?

Have you not been chosen or declined? *

Yes

If Yes, please explain

Have you ever surrendered a pet to a shelter? *

Yes

If Yes, what shelter and when?

If Yes, please explain

CURRENT PETS

Please tell us about any pets you have living in your home now

How many pets live in your home now? *

PET #1

Name of Pet #1

Breed of Pet #1

Age of Pet #1

Pet #1 is:

Male

Female

Pet #1 is Spayed or Neutered

Yes

Do you still own Pet #1?

Yes

Are all Vaccinations current for Pet #1?

Yes

PET #2

Name of Pet #2

Breed of Pet #2

Age of Pet #2

Pet #2 is:

Male

Female

Pet #2 is Spayed or Neutered

Yes

Do you still own Pet #2?

Yes

Are all Vaccinations current for Pet #2?

Yes

Pet #3

Name of Pet #3

Breed of Pet #3

Age of Pet #3

Pet #3 is:

Male

Female

Pet #3 is Spayed or Neutered

Yes

Do you still own Pet #3?

Yes

Are all Vaccinations current for Pet #3?

Yes

Additional Pets:

Please list the same information above for any additional pets you may have in your home at this time

Veterinary Clinic Used:

Clinic Phone #

(###)

###

####

PET HISTORY

Additional Pets owned in the past 5 years

Please list the same information for current pets above for any additional pets you may have had in your home in the past 5 years

Veterinary Clinic Used:

Clinic Phone #

(###)

###

####

FINDING THE BEST MATCH

Please explain the type of personality you are looking for in a new pet: *

Signature

BY TYPING MY NAME BELOW, I CERTIFY THAT THE ABOVE INFORMATION IS TRUE TO MY KNOWLEDGE, AND I RECOGNIZE THAT ANY MISREPRESNTATION OF FACT MAY RESULT IN LOSING ADOPTION PRIVILEGES. I UNDERSTAND THAT COMPLETING AN APPLICATION FOR ANY LISTED ANIMAL DOES NOT GUARANTEE THE ACCEPTANCE AND FINALIZATION OF THE ADOPTION FOR SAID ANIMAL. IN UNDERSTAND THAT IF MY APPLICATION IS NOT CHOSEN FOR SAID ANIMAL, I MAY STILL BE ELIGIBLE TO ADOPT ANOTHER ANIMAL AT ANOTHER TIME FROM BOB'S HOUSE FOR DOGS AND THAT MY APPLICATION WILL BE KEPT ON FILE AT BOB'S HOUSE FOR DOGS I AUTHORIZE INVESTIGATION OF ALL STATEMENTS IN THIS APPLICATION AND UNDERSTAND THAT VETERINARIANS, OTHER ANIMAL SHELTERS, LANDLORDS, ETC. MAY BE CONTACTED. I CERTIFY THAT I AM AT LEAST 18 YEARS OF AGE. I UNDERSTAND THAT THIS APPLICATION IS NOT AN ADOPTION CONTRACT, AND THAT THE ADOPTION WILL BE DELAYED UNTIL MY APPLICATIONS (AND OTHER APPLICATIONS THAT MAY BE RECEIVED FOR THE SAME ANIMAL) HAVE BEEN FULLY PROCESSED.

I agree to the terms stated above *

Yes

Name: *

Date (MM/DD/YYYY) *

YYYY

We will contact you if you are selected to adopt this dog. If you do not hear from our office within 3 business days, the dog you are interested in is no longer available. Your application will b e kept on file and remain active for 30 days.