Pets Alive Animal Sanctuary

Dog Adoption Application

Thank you for your interest in a Pets Alive dog. Please complete the entire application.
Incomplete applications will be returned for completion, thus slowing the application process.

Name (required)
Street Address
City
State
ZIP Code
Home phone
Work phone
Employer
Cell phone
E-mail address (required) Please use an alternate email if you have a yahoo account (if possible). Yahoo delays our responses.
Age
Are you interested in any particular dog(s)? If so, which one(s)?
Otherwise, describe in detail the type of dog you're looking for:
Will this be your first dog?	Yes No
What kind of pets have you had in the past?
Which of these do you still have? Include age, sex and breed.)
Have they been spayed or neutered?	Yes No Don't know
Are they current on vaccinations?	Yes No Don't know
What happened to the pets you no longer have?
Have you ever turned your dog in to a shelter?	Yes No
If yes, please explain:
Have you ever had a pet euthanized?	Yes No
If yes, please explain:
If you have pets, will they adjust to a new dog entering the house?	Yes No Don't know
Why do you want this dog?	Companion Companion for other pet Hunting Breeding Protection Gift Other
If other, please explain:
Where will the dog sleep? (basement? garage? kennel? bed in the house, etc). Please be as specific as possible.
Will the dog be primarily an indoor dog (in the house), or outside/garage dog?
Does everyone living in your home know about and agree with your decision to adopt a dog?	Yes No
If not, why?
How many adults are in your household?
What are the adults' ages and relationship to you?
How many children?
Children's ages?
Does any member of your household have an allergy to dogs?	Yes No
Is someone home during the day?	Yes No
If yes, who?
How many hours each day will the dog be without human companionship?
Please explain:
Where do you live?	House Apartment Condo Mobile home Other
If other, please explain:
Do you own or rent your home?	Own Rent
If you rent, may we contact the owner to obtain permission for this dog to live in your home?	Yes No
Owner's name and phone number:
Do you have a completely fenced yard?	Yes No
If fenced, please describe type of fence and height:
Is there a gate?	Yes No
If there's no gate, please explain:
Do you have a dog door?	Yes No
Where will you keep the dog?	In the house Outdoors Free access both indoors and outdoors In fenced run Other
If other, please explain:
Are there times when the dog will be tied up?	Yes No
If yes, when:
Would you be willing and able to exercise the dog on a regular basis?	Yes No
Exercise method:
Will you keep the dog up-to-date on vaccinations?	Yes No
Please give your veterinarian's name, address and phone number:
If you go away for a few days, or on a vacation, who will take care of the dog?
If you move, will you take the dog with you?	Yes No
Have you ever applied to Pets Alive before to adopt an animal?	Yes No
If yes, when?
Have you ever brought animals to Pets Alive?	Yes No
If yes, please explain:
Are you willing to have a representative of Pets Alive come to see where the dog will be living?	Yes No
If no, explain:
Are you willing to take responsibility of this dog for the next 10 to 15 years?	Yes No
If no, explain:
What provisions will you make for the dog should you become unable to care for him/her?
How much are you willing to spend on medical bills for your dog?	Up to $100 Up to $500 Up to $1,000 Up to $5,000 Whatever it takes
What would you do if the vet bills went over this amount?
Please provide one reference that is NOT your vet or someone living in your home:
Any additional comments?
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